Provider Demographics
NPI:1346845781
Name:RATHNAYAKE, NIROSHA GEETHANI (NP-C)
Entity Type:Individual
Prefix:
First Name:NIROSHA
Middle Name:GEETHANI
Last Name:RATHNAYAKE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 THATCHER WAY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8510
Mailing Address - Country:US
Mailing Address - Phone:248-225-4329
Mailing Address - Fax:
Practice Address - Street 1:1200 S MILITARY HWY STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2251
Practice Address - Country:US
Practice Address - Phone:757-424-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily