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NPI Code Detail

MEDICARE: MIZIANA RAOOFI FNP

MEDICARE: MIZIANA RAOOFI FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse812358TX
2363LF0000XFamily Nurse PractitionerAP128414TX

General Provider Information

NPI Number : 1306220116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIZIANA RAOOFI FNP
Provider Business Mailing Address
First Line : 5937 JANET CT
Second Line :
City : WESTLAKE
State : TX
Zip : 76262-9603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 E JOHN CARPENTER FWY STE 125
Second Line :
City : IRVING
State : TX
Zip : 75062-4299
Country : US
Telephone Number : 972-556-5667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 10/22/2021

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