Individual provider · Type 1 NPI
Farzaneh Moh Entezari, APN
Family Nurse Practitioner · Champaign, IL
NPI number
1770177172
Active
Practice location
1701 Curtis Rd
Champaign, IL 61822-9678
Mailing address
611 W Park St, Fapc
Urbana, IL 61801-2500
Other practice locations
- 414 Paddock Dr W, Savoy, IL 61874-9620 · (217) 550-1777
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 209.022654 (IL) |
| Family Nurse Practitioner Primary | 363LF0000X | 209022654 (IL) |
| Registered Nurse | 163W00000X | 041.438415 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1770177172
Farzaneh Moh Entezari, APN's National Provider Identifier is 1770177172, issued on Feb 25, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Champaign, IL. The record was last updated on Nov 7, 2024.