Provider Demographics
NPI:1407858608
Name:ATHALE, CHANDA R (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:CHANDA
Middle Name:R
Last Name:ATHALE
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7617 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 710
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2603
Mailing Address - Country:US
Mailing Address - Phone:703-941-1732
Mailing Address - Fax:703-941-2108
Practice Address - Street 1:7617 LITTLE RIVER TPKE
Practice Address - Street 2:STE 710
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2616
Practice Address - Country:US
Practice Address - Phone:703-941-1732
Practice Address - Fax:703-941-2108
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024128574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily