MEDICARE: MANINDER KAUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0039580	OH

General Provider Information

NPI Number	:	1508753237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANINDER KAUR

Provider Business Mailing Address
First Line	:	4113 BULRUSH ST
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2571
Country	:	US
Telephone Number	:	937-581-0528
Fax Number	:

Provider Business Practice Location Address
First Line	:	6251 MIAMI VALLEY WAY STE 210A
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-5464
Country	:	US
Telephone Number	:	937-233-2009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	06/24/2025

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Directions to “ MANINDER KAUR ” Practice Location

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