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NPI 1225329139

NPI 1225329139 : FARAMARZ GHANBARI NP : JASPER, TN

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General NPI Number Information
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    NPI Number           |    1225329139
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    Entity Type          |    Individual 
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    Provider Name        |    FARAMARZ GHANBARI NP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/26/2011
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    Last Update Date     |    10/06/2025
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Provider Practice Location Address
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    Address Line         |    503 WESTFIELD PL 
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    City                 |    JASPER
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    State                |    TN
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    Zip                  |    37347-5144
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    Country              |    US
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    Telephone            |    423-651-0300
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    Fax                  |    423-651-0017
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Provider Business Mailing Address
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    Address Line         |    503 WESTFIELD PL 
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    City                 |    JASPER
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    State                |    TN
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    Zip                  |    37347-5144
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    Country              |    US
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    Telephone            |    423-651-0300
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    Fax                  |    423-651-0017
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    APN0000015645
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    License Number State |    TN
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