Provider Demographics
NPI:1619533536
Name:NAWAZ, MURSHED (AGACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MURSHED
Middle Name:
Last Name:NAWAZ
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 EUBANKS RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71275-3369
Mailing Address - Country:US
Mailing Address - Phone:972-375-2473
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PLAZA PL
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3330
Practice Address - Country:US
Practice Address - Phone:318-377-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141583363L00000X, 363LA2100X
LA207182363LA2100X
OK213690363LA2100X
NM74291363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner