Provider Demographics
NPI:1396060521
Name:TEBYANIAN, NESHAT (FNP-C)
Entity type:Individual
Prefix:
First Name:NESHAT
Middle Name:
Last Name:TEBYANIAN
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 1:101 EDUCATION BLVD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2398
Mailing Address - Country:US
Mailing Address - Phone:443-857-8647
Mailing Address - Fax:
Practice Address - Street 1:101 EDUCATION BLVD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2398
Practice Address - Country:US
Practice Address - Phone:443-857-8647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR152177363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily