Healthcare Provider Details

I. General information

NPI: 1699549014
Provider Name (Legal Business Name): KIRANDEEP KAUR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4813 COFFEE RD STE 200
BAKERSFIELD CA
93308-9473
US

IV. Provider business mailing address

PO BOX 1139
BAKERSFIELD CA
93302-1139
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-0252
  • Fax: 661-664-2717
Mailing address:
  • Phone: 661-371-2796
  • Fax: 661-438-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: