Healthcare Provider Details

I. General information

NPI: 1841130531
Provider Name (Legal Business Name): HARPREET SIDHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 TOLL HOUSE AVE STE 209
FREDERICK MD
21701-5901
US

IV. Provider business mailing address

7185 SOMERTON CT
HANOVER MD
21076-1756
US

V. Phone/Fax

Practice location:
  • Phone: 443-963-8339
  • Fax:
Mailing address:
  • Phone: 443-963-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR244120
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: