Provider Demographics
NPI:1750926127
Name:ZAMAN, JASMINE NUROON
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:NUROON
Last Name:ZAMAN
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 1:3475 CANYON OAK WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6982
Mailing Address - Country:US
Mailing Address - Phone:678-361-8158
Mailing Address - Fax:
Practice Address - Street 1:2021 MARKET PLACE BLVD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7931
Practice Address - Country:US
Practice Address - Phone:770-292-9982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61075482363A00000X
GA10285363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant