Basic Information
| Provider Information | |||||||||
| NPI: | 1790240646 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VINODRAO | ||||||||
| FirstName: | HIMABINDU | ||||||||
| MiddleName: | GANGAVARAPU | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9074 PICKWICK VILLAGE TERRACE | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017926168 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8118 | ||||||||
| Address2: | GOOD LUCK ROAD | ||||||||
| City: | LANHHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015528118 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2019 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R132020 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.