Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2013017840 | MO |
NPI | 1033419882 |
---|---|
Provider Name | Mrs. Deepthi C. Kurakula |
First Address | Muncie, IN 47304-4529 |
Second Address | Muncie, IN 47304-4529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2010 |
Last Update Date | 01/09/2015 |