Provider Demographics
NPI:1659188068
Name:PATEL, ROSHANI ANIL (FNP)
Entity type:Individual
Prefix:MRS
First Name:ROSHANI
Middle Name:ANIL
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 OXFORD LN
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-4402
Mailing Address - Country:US
Mailing Address - Phone:302-312-1511
Mailing Address - Fax:
Practice Address - Street 1:212 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-3129
Practice Address - Country:US
Practice Address - Phone:215-699-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily