Provider Demographics
NPI:1629745153
Name:KAUR, JATINDER JIT
Entity Type:Individual
Prefix:
First Name:JATINDER
Middle Name:JIT
Last Name:KAUR
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:JATINDER KAUR
Mailing Address - Street 2:106 SINGER WAY
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5551
Mailing Address - Country:US
Mailing Address - Phone:804-833-2128
Mailing Address - Fax:
Practice Address - Street 1:4505 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6277
Practice Address - Country:US
Practice Address - Phone:919-877-9959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC5015289363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program