MEDICARE: MS. HANNAH DESHEA RIZVI 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
1	363LF0000X	Family Nurse Practitioner	27006	TN

General Provider Information

NPI Number	:	1396375754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH DESHEA RIZVI FNP

Provider Business Mailing Address
First Line	:	1876 LARCHWOOD PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3524
Country	:	US
Telephone Number	:	234-372-4854
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 PRINCETON RD
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-5390
Country	:	US
Telephone Number	:	614-338-5769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2020
Last Update Date	:	09/01/2021

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