Provider Demographics
NPI:1205671492
Name:ARYAL ACHARYA, KALA
Entity type:Individual
Prefix:
First Name:KALA
Middle Name:
Last Name:ARYAL ACHARYA
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 1:103 DIEGO CT APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4431
Mailing Address - Country:US
Mailing Address - Phone:605-592-6358
Mailing Address - Fax:
Practice Address - Street 1:103 DIEGO CT APT D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4431
Practice Address - Country:US
Practice Address - Phone:605-592-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024019624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily