Provider Demographics
NPI:1114803640
Name:NANDAKUMAR, VIJAYALAKSHMI
Entity type:Individual
Prefix:
First Name:VIJAYALAKSHMI
Middle Name:
Last Name:NANDAKUMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12705 E MONTVIEW BLVD STE 355
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7111
Mailing Address - Country:US
Mailing Address - Phone:303-724-7922
Mailing Address - Fax:
Practice Address - Street 1:12705 E MONTVIEW BLVD STE 355
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7111
Practice Address - Country:US
Practice Address - Phone:303-724-7922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician