Provider Demographics
NPI:1285318386
Name:GHUMMAN, HARSIMRAN KAUR (RDN)
Entity type:Individual
Prefix:
First Name:HARSIMRAN
Middle Name:KAUR
Last Name:GHUMMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 CARRIAGE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3048
Mailing Address - Country:US
Mailing Address - Phone:734-335-1017
Mailing Address - Fax:
Practice Address - Street 1:6940 CARRIAGE HILLS DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3048
Practice Address - Country:US
Practice Address - Phone:734-335-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86171313133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered