Provider Demographics
NPI:1053095802
Name:KANDEL, ROSHANI (DNP ARNP FNP-C MPH)
Entity type:Individual
Prefix:DR
First Name:ROSHANI
Middle Name:
Last Name:KANDEL
Suffix:
Gender:F
Credentials:DNP ARNP FNP-C MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-0435
Mailing Address - Country:US
Mailing Address - Phone:605-651-9639
Mailing Address - Fax:
Practice Address - Street 1:902 S 6TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-6441
Practice Address - Country:US
Practice Address - Phone:712-325-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA153012163W00000X
IAA172421363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse