Provider Demographics
NPI:1073814489
Name:BHATTARAI, EVA
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:BHATTARAI
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 1:503 DAVIS BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-7720
Mailing Address - Country:US
Mailing Address - Phone:907-687-8640
Mailing Address - Fax:
Practice Address - Street 1:503 DAVIS BLVD APT A
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-7720
Practice Address - Country:US
Practice Address - Phone:907-687-8640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist