Provider Demographics
NPI:1073296679
Name:KAHLON, RAVINDER KAUR
Entity Type:Individual
Prefix:
First Name:RAVINDER
Middle Name:KAUR
Last Name:KAHLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8747 S BELL MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-2302
Mailing Address - Country:US
Mailing Address - Phone:414-581-7686
Mailing Address - Fax:
Practice Address - Street 1:8747 S BELL MEADOW CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-2302
Practice Address - Country:US
Practice Address - Phone:414-581-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13371-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health