Provider Demographics
NPI:1386284172
Name:BAKHSH, SHAZEEDA (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:SHAZEEDA
Middle Name:
Last Name:BAKHSH
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1619
Mailing Address - Country:US
Mailing Address - Phone:419-893-2775
Mailing Address - Fax:419-893-2776
Practice Address - Street 1:6075 BARKWOOD LN
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2215
Practice Address - Country:US
Practice Address - Phone:567-277-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH026118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily