Individual
NISCHALA NANNAPANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1160 E 3900 S STE 2000, SALT LAKE CITY, UT 84124-1236
(801) 266-3418
(801) 266-4174
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
9342217-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184601239
—
NV
Enumeration date
06/26/2008
Last updated
07/21/2022
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