Provider Demographics
NPI:1376219113
Name:RAMACHANDRAN, SRINITHYA (NP-G)
Entity Type:Individual
Prefix:MRS
First Name:SRINITHYA
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:F
Credentials:NP-G
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N CARON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068-9649
Mailing Address - Country:US
Mailing Address - Phone:815-561-8866
Mailing Address - Fax:877-650-5812
Practice Address - Street 1:915 N CARON RD
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-9649
Practice Address - Country:US
Practice Address - Phone:815-561-8866
Practice Address - Fax:877-650-5812
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023817364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology