Provider Demographics
NPI:1124596762
Name:SIKHRAKAR, SMITA (AGPCNP)
Entity Type:Individual
Prefix:
First Name:SMITA
Middle Name:
Last Name:SIKHRAKAR
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 GAGE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9531
Mailing Address - Country:US
Mailing Address - Phone:509-642-3135
Mailing Address - Fax:509-627-1188
Practice Address - Street 1:560 GAGE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9531
Practice Address - Country:US
Practice Address - Phone:509-642-3135
Practice Address - Fax:509-627-1188
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI228257-30163W00000X
WARN60919284163W00000X
WAAP60919285363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse