MEDICARE: HARPREET KANG PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024179640	VA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11027055	FL

General Provider Information

NPI Number	:	1689292575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARPREET KANG PMHNP

Provider Business Mailing Address
First Line	:	6600 UNIVERSITY PKWY STE 304
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-9048
Country	:	US
Telephone Number	:	804-305-1974
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 UNIVERSITY PKWY STE 304
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-9048
Country	:	US
Telephone Number	:	804-305-1974
Fax Number	:

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

Provider Enumeration Date	:	07/08/2020
Last Update Date	:	06/29/2023

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