Healthcare Provider Details

I. General information

NPI: 1528822053
Provider Name (Legal Business Name): AMEEN F NASSER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AMEEN F NASSER NP

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW GAGE BLVD
TOPEKA KS
66622-0001
US

IV. Provider business mailing address

5222 SW GAGE BLD
TOPEKA KS
66622-0001
US

V. Phone/Fax

Practice location:
  • Phone: 804-676-8717
  • Fax:
Mailing address:
  • Phone: 804-676-8717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024188651
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024188651
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: