Healthcare Provider Details

I. General information

NPI: 1487160933
Provider Name (Legal Business Name): HARDEEP KAUR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9821 ACADEMY RD
PHILADELPHIA PA
19114-1545
US

IV. Provider business mailing address

1101 MARKET ST FL 19
PHILADELPHIA PA
19107-2926
US

V. Phone/Fax

Practice location:
  • Phone: 215-632-8700
  • Fax: 215-632-7865
Mailing address:
  • Phone: 215-481-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSP018344
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: