Provider Demographics
NPI:1508394081
Name:KULSHRESHTHA, VANDANA (RN)
Entity Type:Individual
Prefix:
First Name:VANDANA
Middle Name:
Last Name:KULSHRESHTHA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3674 WINDSONG CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5483
Mailing Address - Country:US
Mailing Address - Phone:440-503-1432
Mailing Address - Fax:
Practice Address - Street 1:24700 CENTER RIDGE RD # 230
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5636
Practice Address - Country:US
Practice Address - Phone:440-503-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN263853163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN263853OtherREGISTERED NURSE