MEDICARE: BASU DHAKAL CRNP

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
1	363LF0000X	Family Nurse Practitioner	SP028151	PA
2	163WG0000X	General Practice Registered Nurse	RN735157	PA

General Provider Information

NPI Number	:	1700669942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BASU DHAKAL CRNP

Provider Business Mailing Address
First Line	:	805 SIR THOMAS CT STE 2
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-4816
Country	:	US
Telephone Number	:	717-657-3030
Fax Number	:	717-671-0991

Provider Business Practice Location Address
First Line	:	805 SIR THOMAS CT STE 2
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-4816
Country	:	US
Telephone Number	:	717-657-3030
Fax Number	:	717-671-0991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	11/24/2025

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