Provider Demographics
NPI:1538231634
Name:THURMAN, ZABRINA YVETTE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ZABRINA
Middle Name:YVETTE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3456 E 17TH ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6757
Mailing Address - Country:US
Mailing Address - Phone:208-529-2828
Mailing Address - Fax:208-529-3890
Practice Address - Street 1:3456 E 17TH ST
Practice Address - Street 2:SUITE 125
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-6757
Practice Address - Country:US
Practice Address - Phone:208-529-2828
Practice Address - Fax:208-529-3890
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA218363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010032423OtherBLUE SHIELD
IDPAZD4OtherBLUE CROSS
ID577448Medicare UPIN