Individual
SANA QUADREE FASIHUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-C
Contact information
Practice address
1118 KIEFER RIDGE CT, BALLWIN, MO 63021-6095
(515) 505-2837
Mailing address
1118 KIEFER RIDGE CT, BALLWIN, MO 63021-6095
(515) 505-2837
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2015039385
MO
363LF0000X
Family Nurse Practitioner
0033324
OH
363LF0000X
Family Nurse Practitioner
113683
NE
363LF0000X
Family Nurse Practitioner
A155882
IA
Other
Enumeration date
08/02/2019
Last updated
07/16/2026
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