Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 0116031644 | VA |
Y | 207RH0002X | Hospice and Palliative Medicine | 83374 | GA |
NPI | 1275920704 |
---|---|
Provider Name | Nikhita Ananthula |
First Address | Marietta, GA 30060-1120 |
Second Address | Marietta, GA 30060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 10/10/2019 |