Provider Demographics
NPI:1699184283
Name:PERERA, HISHANI (FNP)
Entity Type:Individual
Prefix:MRS
First Name:HISHANI
Middle Name:
Last Name:PERERA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8402
Mailing Address - Country:US
Mailing Address - Phone:540-371-4141
Mailing Address - Fax:540-371-1990
Practice Address - Street 1:611 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8402
Practice Address - Country:US
Practice Address - Phone:540-371-4141
Practice Address - Fax:540-371-1990
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily