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RAJPATI BODH-CERES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
209 S HIGH ST, WAYNESBORO, TN 38485-2605
(228) 865-1330
Mailing address
418 MAIN STREET, WAYNESBORO, TN 38384-6003
(731) 727-8012

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
21248
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
461899
RN LICENSE
NY
Enumeration date
12/15/2014
Last updated
01/31/2023
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