Provider Demographics
NPI:1427452770
Name:SALEHANI, NOREN NASRUDDIN (MMSC, PA-C)
Entity type:Individual
Prefix:MRS
First Name:NOREN
Middle Name:NASRUDDIN
Last Name:SALEHANI
Suffix:
Gender:F
Credentials:MMSC, PA-C
Other - Prefix:
Other - First Name:NOREN
Other - Middle Name:NASRUDDIN
Other - Last Name:PANJWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MMSC, PA-C
Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:
Practice Address - Street 1:604 LOVEJOY LN
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-3634
Practice Address - Country:US
Practice Address - Phone:770-268-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1251363A00000X
GA7372363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant