Healthcare Provider Details

I. General information

NPI: 1013478205
Provider Name (Legal Business Name): JASJIT KAUR PATARIA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31500 W 13 MILE RD STE 100
FARMINGTON HILLS MI
48334-2172
US

IV. Provider business mailing address

31500 W 13 MILE RD STE 100
FARMINGTON HILLS MI
48334-2172
US

V. Phone/Fax

Practice location:
  • Phone: 248-509-4070
  • Fax: 248-509-4080
Mailing address:
  • Phone: 248-509-4070
  • Fax: 248-509-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704233494
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: