Healthcare Provider Details

I. General information

NPI: 1932577475
Provider Name (Legal Business Name): SARBJIT KAUR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7230 MARKET ST
BOARDMAN OH
44512
US

IV. Provider business mailing address

152 MORNINGVIEW CIR
CANFIELD OH
44406-8722
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-4549
  • Fax: 330-726-4980
Mailing address:
  • Phone: 330-533-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA 18063-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: