Healthcare Provider Details

I. General information

NPI: 1801254719
Provider Name (Legal Business Name): PRITPAL KAUR SIDHU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 HERNDON AVE
CLOVIS CA
93611-6813
US

IV. Provider business mailing address

2740 HERNDON AVE
CLOVIS CA
93611-6813
US

V. Phone/Fax

Practice location:
  • Phone: 559-299-2608
  • Fax: 559-862-2742
Mailing address:
  • Phone: 559-545-1912
  • Fax: 559-862-2742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95002926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: