Provider Demographics
NPI:1871139162
Name:DONTHI, ANKITH (APRN)
Entity type:Individual
Prefix:
First Name:ANKITH
Middle Name:
Last Name:DONTHI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 OTIS SMITH DR
Mailing Address - Street 2:OTIS SMITH
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043
Mailing Address - Country:US
Mailing Address - Phone:931-553-6666
Mailing Address - Fax:931-553-6681
Practice Address - Street 1:111 OTIS SMITH DR
Practice Address - Street 2:OTIS SMITH
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043
Practice Address - Country:US
Practice Address - Phone:931-553-6666
Practice Address - Fax:931-553-6681
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN26703363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics