Provider Demographics
NPI:1083321764
Name:AHLUWALIA, LOVELEEN K (FNP-BC)
Entity type:Individual
Prefix:
First Name:LOVELEEN
Middle Name:K
Last Name:AHLUWALIA
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:LOVELEEN
Other - Middle Name:K
Other - Last Name:BRAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP -BC
Mailing Address - Street 1:3265 HILLCREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7657
Mailing Address - Country:US
Mailing Address - Phone:541-210-8721
Mailing Address - Fax:541-210-8724
Practice Address - Street 1:296 S PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-6649
Practice Address - Country:US
Practice Address - Phone:416-469-9285
Practice Address - Fax:541-615-9308
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10000672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily