Vidya Nandini Balkishun, PA-C
Physician Assistant in Rehoboth Beach, DE. Individual provider (NPI-1).
NPI number1750432142
StatusActive
Last updated in NPPESOct 21, 2024
Details
- NPI
- 1750432142
- Entity type
- Individual (NPI-1)
- Name
- Vidya Nandini Balkishun
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2007
- Certification date
- Oct 21, 2024
- Last updated
- Oct 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | C5-0012102 | DE | Yes |
| 363AM0700X | Physician Assistant, Medical | MA051675 | PA | |
| 363AM0700X | Physician Assistant, Medical | 4813 | TN |
Practice location
18947 John J Williams Hwy Unit 101Rehoboth Beach, DE 19971-4480
Phone 302-645-3770 · Fax 302-645-5718
Mailing address
1915 White AveKnoxville, TN 37916-2300
Phone 865-331-1720
Other practice locations
1915 White Ave
Knoxville, TN 37916-2300
Knoxville, TN 37916-2300
Phone 865-331-1720
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