Provider Demographics
NPI:1912682345
Name:KRISHNAPURA, SHREYAS GOVINDARANGA
Entity Type:Individual
Prefix:
First Name:SHREYAS
Middle Name:GOVINDARANGA
Last Name:KRISHNAPURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 VANDERBILT PL APT 208
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2533
Mailing Address - Country:US
Mailing Address - Phone:770-568-8726
Mailing Address - Fax:
Practice Address - Street 1:231 ALBERT SABIN WAY RM 6504
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-2533
Practice Address - Country:US
Practice Address - Phone:513-558-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program