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Search › Wisconsin › 152W00000X

Pranaya Bista

NPI 1124792411 · on the registry since 2021

Practice

Address
10996 N Port Washington Rd
Mequon, WI 53092
Phone
(262) 240-9870
Organisation at this address
Shoptikal Llc
Shopko Stores Operating Co Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
152W00000X
152W00000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-08-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin