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General NPI Number Information
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NPI Number | 1619447976
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Entity Type | Individual
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Provider Name | PRATIMA SHRESTHA FNP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 11680 COMMERCIAL DR STE 200
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City | FISHERS
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State | IN
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Zip | 46038
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Country | US
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Telephone | 317-436-8712
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Fax | 317-436-8714
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Provider Business Mailing Address
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Address Line | 11680 COMMERCIAL DR STE 200
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City | FISHERS
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State | IN
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Zip | 46038-2950
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Country | US
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Telephone | 317-436-8712
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Fax | 317-436-8714
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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 | 71008551A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71008551B
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License Number State | IN
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