Jwan M Mustafa, PHARMD
Individual provider Active NPI Pharmacist · Tohatchi, NM
NPI 1154020923 · NPPES record last updated Jun 8, 2024
Key facts
- NPI
- 1154020923
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P10029 (ID)
- Practice address
- PO Box 142
Tohatchi, NM 87325-0142 - Phone
- (505) 733-8415
- NPI assigned
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P10029 | ID | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P10029 | ID | Yes |
Addresses
Primary practice location
PO Box 142
Tohatchi, NM 87325-0142
Mailing address
PO Box 142
Tohatchi, NM 87325-0142
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P10029 | Other | ID | PHARMACIST |
Other providers in Tohatchi, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.