Provider Demographics
NPI:1528602760
Name:BHANSALI, KANIKA ANAND (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:KANIKA
Middle Name:ANAND
Last Name:BHANSALI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HABERSHAM CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3070
Mailing Address - Country:US
Mailing Address - Phone:252-314-4770
Mailing Address - Fax:
Practice Address - Street 1:121 HABERSHAM CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3070
Practice Address - Country:US
Practice Address - Phone:252-314-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant