Provider Demographics
NPI:1417294141
Name:SIDHU, GOVINDER KAUR (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:GOVINDER
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11123 SNOWCREEK FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6692
Mailing Address - Country:US
Mailing Address - Phone:661-868-1292
Mailing Address - Fax:
Practice Address - Street 1:1800 MT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306
Practice Address - Country:US
Practice Address - Phone:661-868-1292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA585233163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health