| Doctor Name: | ANCHALA PRASAD |
| NPI Number: | 1013340926 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CFM02737 |
| Business Practice Address: | 223 E 14th St Suite 5 Hastings, NE - 689013200 |
| Business Phone Number: | 4024614931 |
| Business Fax Number: | 4024614932 |
| Mailing Address: | 223 E 14th St, Suite 5 HASTINGS |
| State: | NE |
| Postal Code: | 689013200 |
| Phone Number: | 4024614931 |
| Fax Number: | 4024614932 |
| NPI Enumeration Date: | 08/14/2013 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 224900000X |
| License Number: | CFM02737 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Mastectomy Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services. |