Basic Information
| Provider Information | |||||||||
| NPI: | 1598152548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QAZI | ||||||||
| FirstName: | ANAM | ||||||||
| MiddleName: | MEHDI | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 KAREN AVE | ||||||||
| Address2: | 2903 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891095313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322311880 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1409 E LAKE MEAD BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890307120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026497711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2015 | ||||||||
| LastUpdateDate: | 10/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP127826 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | APRN002275 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.