Healthcare Provider Details

I. General information

NPI: 1962226852
Provider Name (Legal Business Name): HARINDER KAUR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD
LEXINGTON KY
40504-3751
US

IV. Provider business mailing address

1084 GRIMBALL TRCE
LEXINGTON KY
40509-4621
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5355
  • Fax:
Mailing address:
  • Phone: 818-318-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4028670
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: