Provider Demographics
NPI:1043073760
Name:MUHAMMAD, JAHARAH KHALILAH
Entity type:Individual
Prefix:MRS
First Name:JAHARAH
Middle Name:KHALILAH
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JAHARAH
Other - Middle Name:K
Other - Last Name:MUHAMMAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN MBS
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MS
Mailing Address - Zip Code:39069-0884
Mailing Address - Country:US
Mailing Address - Phone:601-786-7142
Mailing Address - Fax:601-786-8412
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program