Provider Demographics
NPI:1821545559
Name:CHINNASWAMY, SARADAMANI (APRN (AGACNP-BC))
Entity Type:Individual
Prefix:MS
First Name:SARADAMANI
Middle Name:
Last Name:CHINNASWAMY
Suffix:
Gender:F
Credentials:APRN (AGACNP-BC)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6960 SMOKE RANCH RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3204
Mailing Address - Country:US
Mailing Address - Phone:702-384-5101
Mailing Address - Fax:
Practice Address - Street 1:6960 SMOKE RANCH RD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3204
Practice Address - Country:US
Practice Address - Phone:702-384-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN 002266363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care