Provider Demographics
NPI:1760253546
Name:NAGRA, RANJANPREET KAUR (NP)
Entity type:Individual
Prefix:
First Name:RANJANPREET
Middle Name:KAUR
Last Name:NAGRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2695
Mailing Address - Country:US
Mailing Address - Phone:317-225-8005
Mailing Address - Fax:
Practice Address - Street 1:719 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2695
Practice Address - Country:US
Practice Address - Phone:315-464-3265
Practice Address - Fax:315-464-3282
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY811093163WM0705X
NY405847363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical