Provider Demographics
NPI:1871106930
Name:ASIF, MUNIRA
Entity type:Individual
Prefix:
First Name:MUNIRA
Middle Name:
Last Name:ASIF
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 1:874 SCHILLING FARM RD APT 106
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-7039
Mailing Address - Country:US
Mailing Address - Phone:901-453-0563
Mailing Address - Fax:
Practice Address - Street 1:874 SCHILLING FARM RD APT 106
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-7039
Practice Address - Country:US
Practice Address - Phone:901-453-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28161363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care