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General NPI Number Information
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NPI Number | 1326859927
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Entity Type | Individual
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Provider Name | BANDANA BARDEWA FNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 101 WALMART SUPERCENTER
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City | SILER CITY
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State | NC
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Zip | 27344-6755
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Country | US
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Telephone | 919-663-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 4304 WATERFORD VALLEY DR APT 1821
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City | DURHAM
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State | NC
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Zip | 27713-8324
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Country | US
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Telephone | 518-207-8849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 353502
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License Number State | NY
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