Provider Demographics
NPI:1316176431
Name:TAYMUREE, NASREEN
Entity type:Individual
Prefix:
First Name:NASREEN
Middle Name:
Last Name:TAYMUREE
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 1:181 ANDRIEUX ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6932
Mailing Address - Country:US
Mailing Address - Phone:707-938-9880
Mailing Address - Fax:707-938-9879
Practice Address - Street 1:181 ANDRIEUX ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6932
Practice Address - Country:US
Practice Address - Phone:707-938-9880
Practice Address - Fax:707-938-9879
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant