Provider Demographics
NPI:1063395333
Name:THAPA, KANCHAN KATUWAL (NP)
Entity type:Individual
Prefix:
First Name:KANCHAN
Middle Name:KATUWAL
Last Name:THAPA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KANCHAN
Other - Middle Name:
Other - Last Name:KATUWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:924 CROSS LANES DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1315
Mailing Address - Country:US
Mailing Address - Phone:304-776-9872
Mailing Address - Fax:
Practice Address - Street 1:924 CROSS LANES DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25313-1315
Practice Address - Country:US
Practice Address - Phone:304-776-9872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV123073363LA2200X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health