=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215798913
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BABLEEN KAUR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2024
-----------------------------------------------------
Last Update Date | 08/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 940 GOLF HOUSE CT E
-----------------------------------------------------
City | WHITSETT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27377-9296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-449-9848
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1578 RUNNING DEER DR
-----------------------------------------------------
City | KERNERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27284-7173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-253-2378
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 294661
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 5020686
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5020686
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------