Provider Demographics
NPI:1407230261
Name:TIRUNAGARI, KAVITHA RANI (NP)
Entity Type:Individual
Prefix:MRS
First Name:KAVITHA
Middle Name:RANI
Last Name:TIRUNAGARI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 WAYNEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3840
Mailing Address - Country:US
Mailing Address - Phone:484-302-1141
Mailing Address - Fax:
Practice Address - Street 1:312 WAYNEBROOK DR
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-3840
Practice Address - Country:US
Practice Address - Phone:484-302-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-11
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015086363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health