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General NPI Number Information
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NPI Number | 1699877704
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Entity Type | Organization
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Legal Business Name | SEYED-HASSAN NAZIRPOUR-CALOOR CFNP LLC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 612 W 8TH
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City | ROSWELL
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State | NM
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Zip | 88201
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Country | US
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Telephone | 575-623-6161
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Fax | 575-623-6464
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Provider Business Mailing Address
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Address Line | PO BOX 2745
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City | ROSWELL
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State | NM
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Zip | 88202-2745
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Country | US
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Telephone | 575-623-6161
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Fax | 575-623-6464
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | SEYED-HASSAN NAZIRPOUR-CALOOR
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Credential | CFNP
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Telephone | 575-623-6161
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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 | R32057
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License Number State | NM
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