Healthcare Provider Details

I. General information

NPI: 1619533536
Provider Name (Legal Business Name): MURSHED NAWAZ AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PLAZA PL
MINDEN LA
71055-3330
US

IV. Provider business mailing address

309 TANYARD TRCE
BENTON LA
71006-9735
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-2321
  • Fax:
Mailing address:
  • Phone: 972-375-2473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number213690
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number207182
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number74291
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP141583
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP141583
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: