Provider Demographics
NPI:1063978526
Name:KHADKA, MONILA
Entity type:Individual
Prefix:
First Name:MONILA
Middle Name:
Last Name:KHADKA
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 1:411 HIGHLAND VILLAGE DR APT 411
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2401
Mailing Address - Country:US
Mailing Address - Phone:972-330-9201
Mailing Address - Fax:
Practice Address - Street 1:411 HIGHLAND VILLAGE DR APT 411
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2401
Practice Address - Country:US
Practice Address - Phone:972-330-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX960473163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse