Healthcare Provider Details

I. General information

NPI: 1588336796
Provider Name (Legal Business Name): PARAMJIT KAUR RANDHAWA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 12/08/2022
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

5690 LORIPAT DR
BROADVIEW HEIGHTS OH
44147-2269
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3255
  • Fax:
Mailing address:
  • Phone: 216-408-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0029050
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: