Provider Demographics
NPI:1932519071
Name:PATEL, KHYATI
Entity Type:Individual
Prefix:
First Name:KHYATI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LATTNER COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560
Mailing Address - Country:US
Mailing Address - Phone:919-297-0348
Mailing Address - Fax:
Practice Address - Street 1:101 LATTNER COURT
Practice Address - Street 2:SUITE NUMBER 100
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6853
Practice Address - Country:US
Practice Address - Phone:919-297-0348
Practice Address - Fax:919-297-0349
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily