Provider Demographics
NPI:1306990296
Name:ASGARI, NAHID SHIRVANIAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:NAHID
Middle Name:SHIRVANIAN
Last Name:ASGARI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14380 MCGRAWS CORNER DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-1866
Mailing Address - Country:US
Mailing Address - Phone:703-715-9584
Mailing Address - Fax:
Practice Address - Street 1:14380 MCGRAWS CORNER DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-1866
Practice Address - Country:US
Practice Address - Phone:703-715-9584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165097363LF0000X
MDAC000371363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142124ZCCUMedicare PIN
MD123Medicare UPIN