Provider Demographics
NPI:1295380772
Name:FASIHUDDIN, SANA QUADREE (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:QUADREE
Last Name:FASIHUDDIN
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 SE BROWNSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8798
Mailing Address - Country:US
Mailing Address - Phone:270-300-9559
Mailing Address - Fax:
Practice Address - Street 1:230 S 68TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8176
Practice Address - Country:US
Practice Address - Phone:515-608-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily