Provider Demographics
NPI:1063383248
Name:FARHEEN NAAZ, UNKNOWN (MBBS)
Entity type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:FARHEEN NAAZ
Suffix:
Gender:F
Credentials:MBBS
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Other - Last Name:
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Mailing Address - Street 1:7971 S 6TH ST APT 420
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-2037
Mailing Address - Country:US
Mailing Address - Phone:414-334-4084
Mailing Address - Fax:
Practice Address - Street 1:13013 FULLER AVE STE A
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-2687
Practice Address - Country:US
Practice Address - Phone:816-214-5548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2025039773363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant