Provider Demographics
NPI:1952859555
Name:MOHAMMAD NADER, NEEMA (FNP)
Entity Type:Individual
Prefix:
First Name:NEEMA
Middle Name:
Last Name:MOHAMMAD NADER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TRAFALGAR SQ
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9515
Mailing Address - Country:US
Mailing Address - Phone:317-878-2301
Mailing Address - Fax:
Practice Address - Street 1:5550 S EAST ST STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1991
Practice Address - Country:US
Practice Address - Phone:317-534-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2016073237NP-PP363L00000X
IN71013581A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR201607237NP-PPOtherOSBN