Healthcare Provider Details

I. General information

NPI: 1003389081
Provider Name (Legal Business Name): HARPREET KAUR GREWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25639 FORD RD
DEARBORN HEIGHTS MI
48127-4817
US

IV. Provider business mailing address

41517 SANCTUARY LN
CANTON MI
48188-4005
US

V. Phone/Fax

Practice location:
  • Phone: 313-277-3293
  • Fax:
Mailing address:
  • Phone: 419-966-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number470-4349870
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.023503
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number470-4349870
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: