Provider Demographics
NPI:1487682092
Name:HAIDERI, NISREEN ABBAS (MD)
Entity type:Individual
Prefix:
First Name:NISREEN
Middle Name:ABBAS
Last Name:HAIDERI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:NISREEN
Other - Middle Name:
Other - Last Name:HAIDERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12140 NALL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2507
Mailing Address - Country:US
Mailing Address - Phone:913-498-7409
Mailing Address - Fax:913-498-7470
Practice Address - Street 1:12140 NALL AVE STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2507
Practice Address - Country:US
Practice Address - Phone:913-498-7409
Practice Address - Fax:913-498-7470
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021784207R00000X, 207RH0003X
KS04-33380207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology