Provider Demographics
NPI:1891537692
Name:SAHOR, AJI HADDY (FNP-C)
Entity type:Individual
Prefix:
First Name:AJI HADDY
Middle Name:
Last Name:SAHOR
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 1:562 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5382
Mailing Address - Country:US
Mailing Address - Phone:931-854-9601
Mailing Address - Fax:931-854-9605
Practice Address - Street 1:562 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-5382
Practice Address - Country:US
Practice Address - Phone:931-854-9601
Practice Address - Fax:931-854-9605
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1165704363LF0000X
TN36560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty