Basic Information
| Provider Information | |||||||||
| NPI: | 1508155698 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THAPA | ||||||||
| FirstName: | NEHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3150 GERSHWIN DRIVE | ||||||||
| Address2: | |||||||||
| City: | GREEN BAY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 543114328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9203914742 | ||||||||
| FaxNumber: | 9203914731 | ||||||||
| Practice Location | |||||||||
| Address1: | 2017 JEFFERSON ST SW | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240142419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402666961 | ||||||||
| FaxNumber: | 5409859679 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0800X | 61347-20 | WI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.