Healthcare Provider Details

I. General information

NPI: 1538078894
Provider Name (Legal Business Name): FARANAK M. SHARIFI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 CORONADO DR
SALEM VA
24153-5118
US

IV. Provider business mailing address

1312 CORONADO DR
SALEM VA
24153-5118
US

V. Phone/Fax

Practice location:
  • Phone: 540-798-6649
  • Fax:
Mailing address:
  • Phone: 540-798-6649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024198651
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: