Provider Demographics
NPI:1760154272
Name:GANDHI, NIKITA (ARNP)
Entity Type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NIKITA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2550 HAUSER ROSS DRIVE 325
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178
Mailing Address - Country:US
Mailing Address - Phone:408-762-5944
Mailing Address - Fax:408-762-5948
Practice Address - Street 1:2550 HAUSER ROSS DRIVE 325
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178
Practice Address - Country:US
Practice Address - Phone:408-762-5944
Practice Address - Fax:408-762-5948
Is Sole Proprietor?:No
Enumeration Date:2021-10-03
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209024014363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner