Provider Demographics
NPI:1790471894
Name:SHAHANGI, FARSHID (FNP)
Entity Type:Individual
Prefix:
First Name:FARSHID
Middle Name:
Last Name:SHAHANGI
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17212 N SCOTTSDALE RD APT 2253
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9643
Mailing Address - Country:US
Mailing Address - Phone:520-818-8559
Mailing Address - Fax:
Practice Address - Street 1:8008 S JESSE OWENS PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6516
Practice Address - Country:US
Practice Address - Phone:520-818-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ290450363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health