Provider Demographics
NPI:1730664129
Name:MANN, RAMDEEP KAUR (AGPCNP)
Entity Type:Individual
Prefix:MRS
First Name:RAMDEEP
Middle Name:KAUR
Last Name:MANN
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18888 BAYBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-6815
Mailing Address - Country:US
Mailing Address - Phone:678-360-7810
Mailing Address - Fax:
Practice Address - Street 1:18888 BAYBERRY WAY
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-6815
Practice Address - Country:US
Practice Address - Phone:678-360-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704243179363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care