Provider Demographics
NPI:1154779064
Name:SHRESTHA, SONIJA (FNP)
Entity type:Individual
Prefix:
First Name:SONIJA
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5234
Mailing Address - Country:US
Mailing Address - Phone:817-283-0161
Mailing Address - Fax:214-339-7326
Practice Address - Street 1:601 N INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-283-0161
Practice Address - Fax:214-339-7326
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130526364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health