Provider Demographics
NPI:1699538462
Name:NAIR, RESMI RAVEENDRAN (MSN, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RESMI
Middle Name:RAVEENDRAN
Last Name:NAIR
Suffix:
Gender:F
Credentials:MSN, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 GLADWIN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-4002
Mailing Address - Country:US
Mailing Address - Phone:408-601-7678
Mailing Address - Fax:
Practice Address - Street 1:7301 GLADWIN WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-4002
Practice Address - Country:US
Practice Address - Phone:408-601-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022449363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health