Basic Information
| Provider Information | |||||||||
| NPI: | 1629745153 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUR | ||||||||
| FirstName: | JATINDER | ||||||||
| MiddleName: | JIT | ||||||||
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| Mailing Information | |||||||||
| Address1: | JATINDER KAUR | ||||||||
| Address2: | 106 SINGER WAY | ||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275605551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048332128 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4505 FALLS OF NEUSE RD | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276096277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198779959 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2021 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363L00000X | 5015289 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.