Provider Demographics
NPI:1205301272
Name:KAZERANI, SARAH NARGESS (NP-BC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NARGESS
Last Name:KAZERANI
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 DELANO AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6357
Mailing Address - Country:US
Mailing Address - Phone:405-476-9794
Mailing Address - Fax:
Practice Address - Street 1:2500 DELANO AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6357
Practice Address - Country:US
Practice Address - Phone:405-476-9794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily