Healthcare Provider Details

I. General information

NPI: 1235962531
Provider Name (Legal Business Name): SANDEEP KAUR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10777 BRETTRIDGE DR
POWELL OH
43065-7863
US

IV. Provider business mailing address

4961 ROBERTS RD
HILLIARD OH
43026-8129
US

V. Phone/Fax

Practice location:
  • Phone: 614-657-6708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037381
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: