Provider Demographics
NPI:1710423710
Name:GANDHI, HIRALBEN B (FNP)
Entity Type:Individual
Prefix:
First Name:HIRALBEN
Middle Name:B
Last Name:GANDHI
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 1:3844 S LINDBERGH BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1369
Mailing Address - Country:US
Mailing Address - Phone:314-525-0490
Mailing Address - Fax:
Practice Address - Street 1:3844 S LINDBERGH BLVD STE 120
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1369
Practice Address - Country:US
Practice Address - Phone:314-525-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015422363LF0000X
MO2020028165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily