Provider Demographics
NPI:1225535685
Name:SHIRES, GURPREET K (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:GURPREET
Middle Name:K
Last Name:SHIRES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:GURPREET
Other - Middle Name:K
Other - Last Name:MALHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:242 HOSPITAL DR STE B
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4556
Mailing Address - Country:US
Mailing Address - Phone:707-380-1075
Mailing Address - Fax:707-462-7947
Practice Address - Street 1:275 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4531
Practice Address - Country:US
Practice Address - Phone:707-380-1075
Practice Address - Fax:707-462-7947
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK128191363LF0000X
CA95027166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily