Provider Demographics
NPI:1497381115
Name:DE SILVA, INDRIKA NILMINI
Entity Type:Individual
Prefix:
First Name:INDRIKA
Middle Name:NILMINI
Last Name:DE SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 BIG TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5282
Mailing Address - Country:US
Mailing Address - Phone:775-225-1884
Mailing Address - Fax:
Practice Address - Street 1:2275 BIG TRAIL CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5282
Practice Address - Country:US
Practice Address - Phone:775-225-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care