Provider Demographics
NPI:1568850899
Name:AZIMI, PARVANEH YANCHESHMEH (A-GNP C)
Entity type:Individual
Prefix:
First Name:PARVANEH
Middle Name:YANCHESHMEH
Last Name:AZIMI
Suffix:
Gender:F
Credentials:A-GNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 HAWKEN DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-1710
Mailing Address - Country:US
Mailing Address - Phone:972-742-7399
Mailing Address - Fax:
Practice Address - Street 1:2045 HAWKEN DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023
Practice Address - Country:US
Practice Address - Phone:972-742-7399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127094363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health