Healthcare Provider Details

I. General information

NPI: 1669536421
Provider Name (Legal Business Name): SWARANJIT SINGH GILL FNP-C, PMHNP-BC, DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 7TH ST
MADERA CA
93638-3780
US

IV. Provider business mailing address

1718 N CARSON AVE
CLOVIS CA
93619-7443
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-3508
  • Fax: 559-661-2818
Mailing address:
  • Phone: 209-735-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2018079103
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15071
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: