Individual
LATA SHRESTHA PRADHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(904) 372-3943
(904) 212-1618
Mailing address
7751 BELFORT PKWY STE 120, JACKSONVILLE, FL 32256-6921
(904) 372-3943
(904) 212-1618
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R253639
MD
363LF0000X
Family Nurse Practitioner
11018920
FL
Other
Enumeration date
04/13/2022
Last updated
09/11/2025
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