Provider Demographics
NPI:1689440489
Name:RANDHAWA, JASPREET KAUR
Entity Type:Individual
Prefix:
First Name:JASPREET
Middle Name:KAUR
Last Name:RANDHAWA
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 1:7577 BROOKGATE WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-3089
Mailing Address - Country:US
Mailing Address - Phone:216-334-8587
Mailing Address - Fax:
Practice Address - Street 1:7577 BROOKGATE WAY
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-3089
Practice Address - Country:US
Practice Address - Phone:216-334-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHST7263533747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant