Provider Demographics
NPI:1699053553
Name:KOROMA, ZAINABU (FNP)
Entity type:Individual
Prefix:MRS
First Name:ZAINABU
Middle Name:
Last Name:KOROMA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 BROADWAY BLVD
Mailing Address - Street 2:STE 422
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1575
Mailing Address - Country:US
Mailing Address - Phone:972-677-7564
Mailing Address - Fax:
Practice Address - Street 1:3334 BROADWAY BLVD
Practice Address - Street 2:STE 422
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1575
Practice Address - Country:US
Practice Address - Phone:972-979-7408
Practice Address - Fax:972-587-6733
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX647352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily