Provider Demographics
NPI:1447712476
Name:IZNO, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:IZNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2848 S KILLARNEY WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-9040
Mailing Address - Country:US
Mailing Address - Phone:720-400-9462
Mailing Address - Fax:
Practice Address - Street 1:2848 S KILLARNEY WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-9040
Practice Address - Country:US
Practice Address - Phone:720-400-9462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker