Healthcare Provider Details

I. General information

NPI: 1336966159
Provider Name (Legal Business Name): SUKHJIT GILL NP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1374 E ALLUVIAL AVE
FRESNO CA
93720-2608
US

IV. Provider business mailing address

1865 E ALLUVIAL AVE STE 102
FRESNO CA
93720-3855
US

V. Phone/Fax

Practice location:
  • Phone: 559-981-2600
  • Fax: 559-981-2610
Mailing address:
  • Phone: 559-981-2600
  • Fax: 559-981-2610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236488
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95032067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: