Provider Demographics
NPI:1588433346
Name:BHATTARAI, GANDHI (FNP)
Entity type:Individual
Prefix:
First Name:GANDHI
Middle Name:
Last Name:BHATTARAI
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 INDUSTRIAL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1742
Mailing Address - Country:US
Mailing Address - Phone:734-944-8300
Mailing Address - Fax:734-944-8303
Practice Address - Street 1:1235 INDUSTRIAL DR STE 4
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1742
Practice Address - Country:US
Practice Address - Phone:734-944-8300
Practice Address - Fax:734-944-8303
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2023150480363LF0000X
MI4704322675363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily