Provider Demographics
NPI:1518453877
Name:BRIFKANI, NOOR
Entity Type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:BRIFKANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 N WILLOW AVE STE C
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2354
Mailing Address - Country:US
Mailing Address - Phone:931-559-5959
Mailing Address - Fax:833-992-2327
Practice Address - Street 1:427 N WILLOW AVE STE C
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2354
Practice Address - Country:US
Practice Address - Phone:931-559-5959
Practice Address - Fax:833-992-2327
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2134133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric