Healthcare Provider Details

I. General information

NPI: 1053905950
Provider Name (Legal Business Name): NIRMALA DAHAL DHUNGANA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 W MERCURY BLVD
HAMPTON VA
23666-3114
US

IV. Provider business mailing address

2315 W MERCURY BLVD
HAMPTON VA
23666-3114
US

V. Phone/Fax

Practice location:
  • Phone: 757-262-1227
  • Fax:
Mailing address:
  • Phone: 757-262-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024187091
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1030644
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: