Provider Demographics
NPI:1467580282
Name:MOSHREFI, NAHID VENUS KADIR (RESPIRATORYTHERAPIST)
Entity Type:Individual
Prefix:
First Name:NAHID VENUS
Middle Name:KADIR
Last Name:MOSHREFI
Suffix:
Gender:F
Credentials:RESPIRATORYTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 HIGHWAY 105
Mailing Address - Street 2:210
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9165
Mailing Address - Country:US
Mailing Address - Phone:719-219-9646
Mailing Address - Fax:719-302-4560
Practice Address - Street 1:212 WASHINGTON ST
Practice Address - Street 2:F
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9173
Practice Address - Country:US
Practice Address - Phone:719-219-9646
Practice Address - Fax:719-302-4560
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA12039227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered