Provider Demographics
NPI:1821597634
Name:PATEL, KRUTIKA
Entity Type:Individual
Prefix:
First Name:KRUTIKA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 LOUGHBORO RD NW STE 530
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2628
Mailing Address - Country:US
Mailing Address - Phone:202-895-0050
Mailing Address - Fax:202-895-0051
Practice Address - Street 1:5215 LOUGHBORO RD NW STE 530
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2628
Practice Address - Country:US
Practice Address - Phone:202-895-0050
Practice Address - Fax:202-895-0051
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136363363LF0000X
DCRN1058058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily