Healthcare Provider Details

I. General information

NPI: 1689183691
Provider Name (Legal Business Name): AMANPREET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 STOCKDALE HWY STE 275
BAKERSFIELD CA
93309-2667
US

IV. Provider business mailing address

3906 BRIDGEWATER WAY
BAKERSFIELD CA
93313-4264
US

V. Phone/Fax

Practice location:
  • Phone: 661-364-6633
  • Fax:
Mailing address:
  • Phone: 661-364-6633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95092240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: