Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 95004963 | CA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95004963 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95004963 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 95004963 | CA |
NPI | 1528504107 |
---|---|
Provider Name | Sandip Kaur |
First Address | Fresno, CA 93720-2955 |
Second Address | Fresno, CA 93720-2955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2017 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
95004963 | (02) | CA |
95004963 | (05) | CA |