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NPI Code Detail

MEDICARE: KAVYA VANCHIPURAKAL FNP-BC, BSN, RN

MEDICARE: KAVYA VANCHIPURAKAL FNP-BC, BSN, RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse704999NY
2163W00000XRegistered Nurse1053765TX
3363LF0000XFamily Nurse Practitioner345824NY
4363LF0000XFamily Nurse Practitioner1053765TX

General Provider Information

NPI Number : 1659748499
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAVYA VANCHIPURAKAL FNP-BC, BSN, RN
Provider Business Mailing Address
First Line : 2140 MEDICAL DISTRICT DR APT 3102
Second Line :
City : DALLAS
State : TX
Zip : 75235-8278
Country : US
Telephone Number : 845-536-4809
Fax Number :
Provider Business Practice Location Address
First Line : 4708 ALLIANCE BLVD STE 550
Second Line :
City : PLANO
State : TX
Zip : 75093-5363
Country : US
Telephone Number : 469-800-6580
Fax Number : 469-800-6590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2015
Last Update Date : 05/23/2024

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