Provider Demographics
NPI:1346050739
Name:NEPAL, SHANTI
Entity type:Individual
Prefix:
First Name:SHANTI
Middle Name:
Last Name:NEPAL
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 1:1026 MERRY ELM LN
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3260
Mailing Address - Country:US
Mailing Address - Phone:518-698-3675
Mailing Address - Fax:
Practice Address - Street 1:1026 MERRY ELM LN
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3260
Practice Address - Country:US
Practice Address - Phone:518-698-3675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR266537363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology