Healthcare Provider Details

I. General information

NPI: 1962063081
Provider Name (Legal Business Name): SRAVANI LOKINENI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 STARLITE DR
HENDERSON KY
42420-6102
US

IV. Provider business mailing address

PO BOX 632111
CINCINNATI OH
45263-2306
US

V. Phone/Fax

Practice location:
  • Phone: 812-426-9311
  • Fax: 812-858-4535
Mailing address:
  • Phone: 812-450-6879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number58710
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: