Healthcare Provider Details

I. General information

NPI: 1760019806
Provider Name (Legal Business Name): HARSIMRAT KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 N MARKS AVE
FRESNO CA
93722-4555
US

IV. Provider business mailing address

4639 W NAOMI WAY
FRESNO CA
93722-4327
US

V. Phone/Fax

Practice location:
  • Phone: 559-860-4925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95014068
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: