Healthcare Provider Details

I. General information

NPI: 1518781970
Provider Name (Legal Business Name): NIKITA DHUNGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10640 N RIVERSIDE DR STE 300
FORT WORTH TX
76244-9507
US

IV. Provider business mailing address

10640 N RIVERSIDE DR STE 300
FORT WORTH TX
76244-9507
US

V. Phone/Fax

Practice location:
  • Phone: 817-722-6078
  • Fax:
Mailing address:
  • Phone: 817-722-6078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1179893
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: