Provider Demographics
NPI:1013599109
Name:LAMICHHANE, SHRADDHA
Entity Type:Individual
Prefix:
First Name:SHRADDHA
Middle Name:
Last Name:LAMICHHANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10892 CARAWAY CIR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-8217
Mailing Address - Country:US
Mailing Address - Phone:703-980-2783
Mailing Address - Fax:
Practice Address - Street 1:10892 CARAWAY CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-8217
Practice Address - Country:US
Practice Address - Phone:703-980-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily