Healthcare Provider Details

I. General information

NPI: 1891612842
Provider Name (Legal Business Name): NEERU VIRK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6608 MERCY CT STE B
FAIR OAKS CA
95628-3171
US

IV. Provider business mailing address

6830 WALERGA RD APT 45
SACRAMENTO CA
95842-1868
US

V. Phone/Fax

Practice location:
  • Phone: 916-241-9844
  • Fax: 916-241-9845
Mailing address:
  • Phone: 530-701-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: