Provider Demographics
NPI:1275136558
Name:KIARIE PRIYA HEALTHCARE PLLC
Entity Type:Organization
Organization Name:KIARIE PRIYA HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:PRIYA
Authorized Official - Last Name:SRIKANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-979-2284
Mailing Address - Street 1:2202 COMBES ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-6812
Mailing Address - Country:US
Mailing Address - Phone:217-979-2284
Mailing Address - Fax:
Practice Address - Street 1:902 N COUNTRY FAIR DR UNIT 3
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-2300
Practice Address - Country:US
Practice Address - Phone:765-560-3864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty