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Individual

VIDYA K MANDHARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN MSN FNPC

Contact information

Practice address
2222 SIMON BOLIVAR AVE, FL 2, NEW ORLEANS, LA 70113-1460
(504) 658-2785
(504) 658-2784
Mailing address
2222 SIMON BOLIVAR AVE, FL 2, NEW ORLEANS, LA 70113-1460
(504) 363-4711
(504) 363-4741

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN087376
LA
363LF0000X
Family Nurse Practitioner
Primary
AP020536
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1782661
LA
Enumeration date
07/05/2006
Last updated
02/17/2017
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