Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95017366 | CA |
NPI | 1053902130 |
---|---|
Provider Name | Simranjot Kaur Thind |
First Address | Shingletown, CA 96088-9462 |
Second Address | Shingletown, CA 96088-9462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2021 |
Last Update Date | 30/06/2021 |