Healthcare Provider Details

I. General information

NPI: 1831513274
Provider Name (Legal Business Name): LAKSHYA NAIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: N A

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S FREDERICK AVE STE 213
GAITHERSBURG MD
20877-1282
US

IV. Provider business mailing address

604 S FREDERICK AVE STE 213
GAITHERSBURG MD
20877-1282
US

V. Phone/Fax

Practice location:
  • Phone: 240-498-7448
  • Fax:
Mailing address:
  • Phone: 240-498-7448
  • Fax: 240-399-4341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR256329
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP500226214
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024171394
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: