Healthcare Provider Details

I. General information

NPI: 1720700610
Provider Name (Legal Business Name): NAVNEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 CALUMET AVE
MUNSTER IN
46321-1701
US

IV. Provider business mailing address

6316 PERSHING RD
SCHERERVILLE IN
46375-3451
US

V. Phone/Fax

Practice location:
  • Phone: 219-513-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10003807A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: