Provider Demographics
NPI:1750048187
Name:RUPANI, MOHSIN (FNP, RN)
Entity Type:Individual
Prefix:
First Name:MOHSIN
Middle Name:
Last Name:RUPANI
Suffix:
Gender:M
Credentials:FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 WINFORD PL
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8447
Mailing Address - Country:US
Mailing Address - Phone:404-428-3206
Mailing Address - Fax:
Practice Address - Street 1:325 WINFORD PL
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-8447
Practice Address - Country:US
Practice Address - Phone:404-428-3206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN277409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN277409OtherGA BOARD OF NURSING