Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101261058 | VA |
N | 111NI0900X | Internist | 0101261058 | VA |
Y | 207RS0012X | Sleep Medicine | 0101261058 | VA |
NPI | 1366799785 |
---|---|
Provider Name | Vaishnavi Challapalli Sri |
First Address | Portsmouth, VA 23707-0068 |
Second Address | Suffolk, VA 23434-4259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2012 |
Last Update Date | 29/07/2019 |