Individual
BIMALA DEVKOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N 26TH ST STE 201, WABASH VALLEY ALLIANCE, LAFAYETTE, IN 47904-2856
(765) 446-6540
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7169
(574) 269-4189
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28221672A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71005486A
IN
Other
Enumeration date
06/10/2015
Last updated
12/06/2017
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