Provider Demographics
NPI:1235667965
Name:CARDOSI, FARAH F (DNP)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:F
Last Name:CARDOSI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P O BOX 1000 DEPT 978
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-758-9900
Mailing Address - Fax:901-752-2335
Practice Address - Street 1:7550 WOLF RIVER BLVD STE 103
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1779
Practice Address - Country:US
Practice Address - Phone:901-761-9097
Practice Address - Fax:901-682-7635
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN22829363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ029698Medicaid
TN6115070OtherBCBS