Healthcare Provider Details

I. General information

NPI: 1952833394
Provider Name (Legal Business Name): KULWINDER NICOLE BAJWA CNM, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 LONE STAR RD STE 200
MANSFIELD TX
76063-8751
US

IV. Provider business mailing address

3751 HERITAGE TOWNE BLVD APT#4218
GRAND PRAIRIE TX
07065
US

V. Phone/Fax

Practice location:
  • Phone: 682-268-6707
  • Fax:
Mailing address:
  • Phone: 973-886-8294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1175010
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1175010
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: