Provider Demographics
NPI:1962046672
Name:KAUR, KAMALJIT (APRN)
Entity type:Individual
Prefix:
First Name:KAMALJIT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 BELLA ROSA CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5238
Mailing Address - Country:US
Mailing Address - Phone:407-688-4384
Mailing Address - Fax:
Practice Address - Street 1:129 BELLA ROSA CIR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-5238
Practice Address - Country:US
Practice Address - Phone:407-688-4384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily