Provider Demographics
NPI:1578165387
Name:KAUR, SUKHPREET (RN)
Entity Type:Individual
Prefix:
First Name:SUKHPREET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 MCCORMICK DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-3848
Mailing Address - Country:US
Mailing Address - Phone:206-353-0204
Mailing Address - Fax:
Practice Address - Street 1:2209 JOHN R WOODEN DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-1840
Practice Address - Country:US
Practice Address - Phone:800-782-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INAP61523897363L00000X
IN71014828A363L00000X
WARN60800419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner