Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 81735 | GA |
NPI | 1154776482 |
---|---|
Provider Name | Nazish Haqqani |
First Address | Augusta, GA 30901-2608 |
Second Address | Augusta, GA 30901-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2016 |
Last Update Date | 29/04/2021 |