Provider Demographics
NPI:1245314871
Name:KASHANI, MARIAM DIDDEN (CRNP)
Entity type:Individual
Prefix:MS
First Name:MARIAM
Middle Name:DIDDEN
Last Name:KASHANI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9921 BRIXTON LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1525
Mailing Address - Country:US
Mailing Address - Phone:301-469-6352
Mailing Address - Fax:
Practice Address - Street 1:9921 BRIXTON LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1525
Practice Address - Country:US
Practice Address - Phone:301-469-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180113363LP0808X
MDR137718363LP0808X
DCRN66266363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health