Provider Demographics
NPI:1720851264
Name:SHAFIEI, NARGES
Entity type:Individual
Prefix:
First Name:NARGES
Middle Name:
Last Name:SHAFIEI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11114 W 113TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2744
Mailing Address - Country:US
Mailing Address - Phone:310-598-9582
Mailing Address - Fax:
Practice Address - Street 1:500 STATE HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1813
Practice Address - Country:US
Practice Address - Phone:913-755-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5382589091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily