=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962195222
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARU MAHARJAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2023
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 57 ATKINSON RD
-----------------------------------------------------
City | SUMRALL
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39482-9551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-313-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 CENTER ST APT B
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29649-1129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-313-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5018192
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------