Provider Demographics
NPI:1871136994
Name:DHAKAL, ROSHA (AGNP-C)
Entity type:Individual
Prefix:
First Name:ROSHA
Middle Name:
Last Name:DHAKAL
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16580 E HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4114
Mailing Address - Country:US
Mailing Address - Phone:585-789-7949
Mailing Address - Fax:
Practice Address - Street 1:400 INDIANA ST STE 280
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5069
Practice Address - Country:US
Practice Address - Phone:303-985-1811
Practice Address - Fax:303-985-3917
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995025363LX0106X
COAPN.0995025-NP363LF0000X, 225000000X, 163WP0000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No163WP0000XNursing Service ProvidersRegistered NursePain ManagementGroup - Multi-Specialty