Provider Demographics
NPI:1730675679
Name:RAVASH, NAVDEEP KAUR
Entity Type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:KAUR
Last Name:RAVASH
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 1:370 NEFF AVE STE I-11
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3438
Mailing Address - Country:US
Mailing Address - Phone:540-578-1562
Mailing Address - Fax:571-313-8207
Practice Address - Street 1:370 NEFF AVE STE I-11
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3438
Practice Address - Country:US
Practice Address - Phone:540-578-1562
Practice Address - Fax:571-313-8207
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO18323747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA82-2179732Medicaid