Provider Demographics
NPI:1962643924
Name:SHRESTHA, USHA BADE
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:BADE
Last Name:SHRESTHA
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 1:209 COLUMBIA DR SE
Mailing Address - Street 2:APT # 37
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-3648
Mailing Address - Country:US
Mailing Address - Phone:505-400-9214
Mailing Address - Fax:
Practice Address - Street 1:209 COLUMBIA DR SE
Practice Address - Street 2:APT # 37
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-3648
Practice Address - Country:US
Practice Address - Phone:505-400-9214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program