Individual
NISHA ANU PRAKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4000
Mailing address
PO BOX 755, SYLVANIA, OH 43560-0755
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
DR.0054281
CO
Other
Enumeration date
04/06/2010
Last updated
03/17/2018
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