Individual
SOUROUSH MOHAMMED NIKNAHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-2877
(502) 587-4404
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1149312
KY
Other
Enumeration date
11/08/2023
Last updated
03/11/2024
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