Provider Demographics
NPI:1861200743
Name:GHASEMI, AREZOO (FNP)
Entity type:Individual
Prefix:
First Name:AREZOO
Middle Name:
Last Name:GHASEMI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 S DOUBLOON CT UNIT D
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2058
Mailing Address - Country:US
Mailing Address - Phone:480-299-2284
Mailing Address - Fax:
Practice Address - Street 1:2929 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-8034
Practice Address - Country:US
Practice Address - Phone:602-470-5000
Practice Address - Fax:602-470-5063
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ314421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily