Provider Demographics
NPI:1952366965
Name:SHRESTHA, NATALIA A (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:A
Last Name:SHRESTHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-277-1570
Mailing Address - Fax:859-277-1595
Practice Address - Street 1:1221 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2701
Practice Address - Country:US
Practice Address - Phone:859-277-1570
Practice Address - Fax:859-277-1595
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64332067Medicaid
KYP00461319OtherRR MEDICARE
KYK083580Medicare PIN
KY0169Medicare PIN
KY64332067Medicaid
KYH26931Medicare UPIN