Healthcare Provider Details

I. General information

NPI: 1518807932
Provider Name (Legal Business Name): NIKITHA CHOWDARY CHANDRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HCA FLORIDA CAPITAL HOSPITAL 2626 CARE DRIVE
TALLAHASSEE FL
32308
US

IV. Provider business mailing address

1759 E VILLA DR STE 111
COTTONWOOD AZ
86326-4681
US

V. Phone/Fax

Practice location:
  • Phone: 850-325-5932
  • Fax:
Mailing address:
  • Phone: 928-301-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR82161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: