Healthcare Provider Details

I. General information

NPI: 1174487821
Provider Name (Legal Business Name): GURJIT KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1648 SILVER GLEN AVE
LAS VEGAS NV
89123-3847
US

IV. Provider business mailing address

1648 SILVER GLEN AVE
LAS VEGAS NV
89123-3847
US

V. Phone/Fax

Practice location:
  • Phone: 702-580-5925
  • Fax:
Mailing address:
  • Phone: 702-580-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number822304
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: