Provider Demographics
NPI:1770997678
Name:ZAHEDI, AARON GLENN (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:GLENN
Last Name:ZAHEDI
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6624
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39506-6624
Mailing Address - Country:US
Mailing Address - Phone:228-254-1611
Mailing Address - Fax:228-236-3710
Practice Address - Street 1:1636 POPPS FERRY RD STE 107
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2214
Practice Address - Country:US
Practice Address - Phone:228-254-1611
Practice Address - Fax:228-236-3710
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR890849363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily