Provider Demographics
NPI:1871071043
Name:SAID, NAZYRA H
Entity type:Individual
Prefix:MISS
First Name:NAZYRA
Middle Name:H
Last Name:SAID
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 1:4208 RUSSELL AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1721
Mailing Address - Country:US
Mailing Address - Phone:240-906-0685
Mailing Address - Fax:
Practice Address - Street 1:4208 RUSSELL AVE APT 4
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1721
Practice Address - Country:US
Practice Address - Phone:240-906-0685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12507374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11351108470Medicaid