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General NPI Number Information
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NPI Number | 1780566158
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Entity Type | Individual
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Provider Name | FARAH ATTAULLAH FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 21471 N LAKE PLEASANT PKWY STE 1710
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City | PEORIA
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State | AZ
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Zip | 85382-0001
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Country | US
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Telephone | 480-677-8282
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Fax | 888-316-1686
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Provider Business Mailing Address
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Address Line | 261 N ROOSEVELT AVE
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City | CHANDLER
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State | AZ
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Zip | 85226-2617
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Country | US
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Telephone | 480-677-8282
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Fax | 888-316-1686
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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 | 269510
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License Number State | AZ
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