Pallavi Reddy Muddasani Bhasyam, FNP
Nurse Practitioner, Family in Lapel, IN. Individual provider (NPI-1).
NPI number1902503261
StatusActive
Last updated in NPPESApr 3, 2024
Details
- NPI
- 1902503261
- Entity type
- Individual (NPI-1)
- Name
- Pallavi Reddy Muddasani Bhasyam
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 7, 2023
- Certification date
- Apr 3, 2024
- Last updated
- Apr 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 71013615A | IN | Yes |
| 363LP2300X | Nurse Practitioner, Primary Care | 28254959A | IN |
Practice location
299 E Pendleton Ave # 547Lapel, IN 46051-5546
Phone 765-534-3636 · Fax 765-534-3638
Mailing address
12286 Whispering Breeze DrFishers, IN 46037-4452
Phone 765-609-0506
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