Provider Demographics
NPI:1790240646
Name:VINODRAO, HIMABINDU GANGAVARAPU (FNP)
Entity Type:Individual
Prefix:
First Name:HIMABINDU
Middle Name:GANGAVARAPU
Last Name:VINODRAO
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 1:9074 PICKWICK VILLAGE TERRACE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:301-792-6168
Mailing Address - Fax:
Practice Address - Street 1:8118
Practice Address - Street 2:GOOD LUCK ROAD
Practice Address - City:LANHHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-552-8118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR132020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty