Provider Demographics
NPI:1568150639
Name:EFFENDI, MUHAMMED WALEED (MSN-FNP-C)
Entity type:Individual
Prefix:
First Name:MUHAMMED
Middle Name:WALEED
Last Name:EFFENDI
Suffix:
Gender:M
Credentials:MSN-FNP-C
Other - Prefix:
Other - First Name:WALEED
Other - Middle Name:
Other - Last Name:EFFENDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 MEDICAL PLAZA DR STE 175
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3049
Mailing Address - Country:US
Mailing Address - Phone:916-782-2146
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL PLAZA DR STE 175
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3049
Practice Address - Country:US
Practice Address - Phone:916-782-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF11210580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily