Provider Demographics
NPI:1487129912
Name:PATEL, NILAY C (CA FNP AANP)
Entity type:Individual
Prefix:
First Name:NILAY
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:CA FNP AANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4772 W MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-7777
Mailing Address - Country:US
Mailing Address - Phone:559-473-9147
Mailing Address - Fax:
Practice Address - Street 1:4772 W MORRIS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-7777
Practice Address - Country:US
Practice Address - Phone:559-473-9147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95010103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily