Provider Demographics
NPI:1508317413
Name:BHANDARI, RASTRIYATA (FNP)
Entity type:Individual
Prefix:
First Name:RASTRIYATA
Middle Name:
Last Name:BHANDARI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RASTRIYATA
Other - Middle Name:
Other - Last Name:SUBEDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 749112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9112
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:303-825-7927
Practice Address - Street 1:4376 GERMANNA HWY
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:VA
Practice Address - Zip Code:22508-2008
Practice Address - Country:US
Practice Address - Phone:540-972-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131709363LF0000X
COC-RXN.0000259-C-NP363LF0000X
VA0024186263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily