Provider Demographics
NPI:1710445267
Name:RAHAT, SHEEBA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHEEBA
Middle Name:
Last Name:RAHAT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHEEBA
Other - Middle Name:
Other - Last Name:MEMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2046 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4481
Mailing Address - Country:US
Mailing Address - Phone:267-255-0990
Mailing Address - Fax:
Practice Address - Street 1:2046 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4481
Practice Address - Country:US
Practice Address - Phone:267-255-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02190152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily