Healthcare Provider Details

I. General information

NPI: 1336032093
Provider Name (Legal Business Name): TARAN KAUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1679 OLD FANNIN RD STE E
FLOWOOD MS
39232-8101
US

IV. Provider business mailing address

751 GLENWILD DR
CANTON MS
39046-7060
US

V. Phone/Fax

Practice location:
  • Phone: 601-398-1949
  • Fax:
Mailing address:
  • Phone: 601-946-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number906680
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: