Healthcare Provider Details

I. General information

NPI: 1407385768
Provider Name (Legal Business Name): RUPINDERJIT KAUR GILL MSN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 WEST SAN JOSE AVE. APT.136
FRESNO CA
93711
US

IV. Provider business mailing address

5664 E LAURITE AVE
FRESNO CA
93727-6428
US

V. Phone/Fax

Practice location:
  • Phone: 559-994-5595
  • Fax:
Mailing address:
  • Phone: 559-218-0415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95035034
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN265375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: