Provider Demographics
NPI:1609277052
Name:DHINDSA, MANDEEP KAUR
Entity Type:Individual
Prefix:
First Name:MANDEEP
Middle Name:KAUR
Last Name:DHINDSA
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 1:101 BATTLEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-2598
Mailing Address - Country:US
Mailing Address - Phone:703-867-3406
Mailing Address - Fax:
Practice Address - Street 1:1212 N MILDRED ST
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-5552
Practice Address - Country:US
Practice Address - Phone:304-724-6091
Practice Address - Fax:304-725-7204
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN83314-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily