Provider Demographics
NPI:1912251307
Name:CHOWDHURY, KRISHNA (NP)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:
Last Name:CHOWDHURY
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 1:303 W KATELLA AVE
Mailing Address - Street 2:SUITE 272
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-4750
Mailing Address - Country:US
Mailing Address - Phone:714-633-1400
Mailing Address - Fax:
Practice Address - Street 1:303 W KATELLA AVE
Practice Address - Street 2:SUITE 272
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4750
Practice Address - Country:US
Practice Address - Phone:714-633-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 22330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily