Healthcare Provider Details

I. General information

NPI: 1326830761
Provider Name (Legal Business Name): MANPREET KAUR MOKHA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16246 W 156TH TER
OLATHE KS
66062-3864
US

IV. Provider business mailing address

16246 W 156TH TER
OLATHE KS
66062-3864
US

V. Phone/Fax

Practice location:
  • Phone: 913-406-2630
  • Fax:
Mailing address:
  • Phone: 913-406-2630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-84355-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: