Individual
RAJITHA BOMMAKANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
13225 CARIS CT, ALPHARETTA, GA 30009-3249
(919) 656-1029
Mailing address
13225 CARIS CT, ALPHARETTA, GA 30009-3249
(919) 656-1029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN208614
GA
163WC0400X
Case Management Registered Nurse
RN208614
GA
163WC1500X
Community Health Registered Nurse
RN208614
GA
163WD0400X
Diabetes Educator Registered Nurse
RN208614
GA
163WD1100X
Peritoneal Dialysis Registered Nurse
RN208614
GA
163WH0200X
Home Health Registered Nurse
RN208614
GA
163WH0500X
Hemodialysis Registered Nurse
RN208614
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN208614
RN
GA
Enumeration date
09/08/2018
Last updated
11/22/2018
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