Healthcare Provider Details

I. General information

NPI: 1659264976
Provider Name (Legal Business Name): PREKSHA SAPKOTA GAUTAM APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 MIKE PADGETT HWY
AUGUSTA GA
30906-3815
US

IV. Provider business mailing address

830 HIGH GREEN CT
GROVETOWN GA
30813-3940
US

V. Phone/Fax

Practice location:
  • Phone: 706-432-4837
  • Fax:
Mailing address:
  • Phone: 210-986-2159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberAPRN-NP276871
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: