Provider Demographics
NPI:1679235063
Name:DZIMIRA, IZABELA (FNP-C)
Entity type:Individual
Prefix:
First Name:IZABELA
Middle Name:
Last Name:DZIMIRA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7150 HAMILTON BLVD UNIT 400
Practice Address - Street 2:
Practice Address - City:TREXLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18087-9734
Practice Address - Country:US
Practice Address - Phone:610-351-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024529363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily