Healthcare Provider Details

I. General information

NPI: 1891293585
Provider Name (Legal Business Name): VARSHNA NARUMANCHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2018
Last Update Date: 07/02/2022
Certification Date: 07/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13805 ANN PLACE LOTUS HOUSE 2ND FLOOR
AUSTIN TX
78728
US

IV. Provider business mailing address

11403 HORNSBY ST
AUSTIN TX
78753-2627
US

V. Phone/Fax

Practice location:
  • Phone: 512-736-4591
  • Fax: 512-957-2702
Mailing address:
  • Phone: 512-736-4591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-302878
License Number StateZZ
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-302878
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number99319
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: