Provider Demographics
NPI:1972313146
Name:MUPANDASEKWA, TULANY (NP)
Entity type:Individual
Prefix:
First Name:TULANY
Middle Name:
Last Name:MUPANDASEKWA
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6218 TRAIL RIDE DR
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-0060
Mailing Address - Country:US
Mailing Address - Phone:434-603-9027
Mailing Address - Fax:434-603-9027
Practice Address - Street 1:6218 TRAIL RIDE DR
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-0060
Practice Address - Country:US
Practice Address - Phone:434-603-9027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192707363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health