Healthcare Provider Details

I. General information

NPI: 1740918325
Provider Name (Legal Business Name): MANMEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4043 STOCKDALE HWY
BAKERSFIELD CA
93309-2021
US

IV. Provider business mailing address

5518 STILLWATER DR
BAKERSFIELD CA
93313-4931
US

V. Phone/Fax

Practice location:
  • Phone: 661-412-9391
  • Fax:
Mailing address:
  • Phone: 661-497-2709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032300
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95269485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: