Provider Demographics
NPI:1801964028
Name:KAHATAPITIYA, DILRUKSHIE MARIA (NP)
Entity type:Individual
Prefix:
First Name:DILRUKSHIE
Middle Name:MARIA
Last Name:KAHATAPITIYA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 KEMPSVILLE RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-5999
Mailing Address - Fax:
Practice Address - Street 1:850 KEMPSVILLE RD STE 200B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167158363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10019827NOtherOPTIMA/SENTARA
VA1801964028Medicaid
VAP00394035Medicare PIN
VA013185C92Medicare PIN
Q74898Medicare UPIN