Provider Demographics
NPI:1457194896
Name:BENIPAL, SUKHVIR KAUR
Entity type:Individual
Prefix:
First Name:SUKHVIR
Middle Name:KAUR
Last Name:BENIPAL
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 1:10222 SAND RUN LN
Mailing Address - Street 2:
Mailing Address - City:FORTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46040-4533
Mailing Address - Country:US
Mailing Address - Phone:317-792-0957
Mailing Address - Fax:
Practice Address - Street 1:9550 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1201
Practice Address - Country:US
Practice Address - Phone:317-842-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015382A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily