Provider Demographics
NPI:1235021726
Name:DHILLON, RUPINDERJEET KAUR
Entity type:Individual
Prefix:
First Name:RUPINDERJEET
Middle Name:KAUR
Last Name:DHILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUPINDER JEET
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:392 LARCHMONT WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-2047
Mailing Address - Country:US
Mailing Address - Phone:570-578-0197
Mailing Address - Fax:
Practice Address - Street 1:301 GREY LINE DR
Practice Address - Street 2:
Practice Address - City:FRACKVILLE
Practice Address - State:PA
Practice Address - Zip Code:17932-0100
Practice Address - Country:US
Practice Address - Phone:570-773-2158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP032147363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care