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NPI Code Detail

MEDICARE: DR. RANI PRASAD VARGHESE FNP

MEDICARE: DR. RANI PRASAD VARGHESE FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP115015TX

General Provider Information

NPI Number : 1689867657
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANI PRASAD VARGHESE FNP
Provider Business Mailing Address
First Line : PO BOX 746079
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6079
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1515 S BUCKNER BLVD STE 141
Second Line :
City : DALLAS
State : TX
Zip : 75217-1794
Country : US
Telephone Number : 214-305-7065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2007
Last Update Date : 07/12/2024

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