Provider Demographics
NPI:1477995777
Name:RADHAKRISHNA, ROSHNI (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSHNI
Middle Name:
Last Name:RADHAKRISHNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 EASTBROOK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5744
Mailing Address - Country:US
Mailing Address - Phone:970-493-7733
Mailing Address - Fax:
Practice Address - Street 1:3351 EASTBROOK DR STE 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5744
Practice Address - Country:US
Practice Address - Phone:970-493-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-27
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0068436207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology