Provider Demographics
NPI:1700669942
Name:DHAKAL, BASU (CRNP)
Entity Type:Individual
Prefix:
First Name:BASU
Middle Name:
Last Name:DHAKAL
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SIR THOMAS CT STE 2
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4816
Mailing Address - Country:US
Mailing Address - Phone:717-657-3030
Mailing Address - Fax:717-671-0991
Practice Address - Street 1:805 SIR THOMAS CT STE 2
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4816
Practice Address - Country:US
Practice Address - Phone:717-657-3030
Practice Address - Fax:717-671-0991
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN735157163WG0000X
PASP028151363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice