MEDICARE: AMANDEEP KAUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	95246762	CA

General Provider Information

NPI Number	:	1205552205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDEEP KAUR

Provider Business Mailing Address
First Line	:	1643 LION ST
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-5735
Country	:	US
Telephone Number	:	206-724-9339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1643 LION ST
Second Line	:
City	:	ROCKLIN
State	:	CA
Zip	:	95765-5735
Country	:	US
Telephone Number	:	206-724-9339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	10/12/2022

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Directions to “ AMANDEEP KAUR ” Practice Location

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