Provider Demographics
NPI:1437819968
Name:TIWANA, GURPREET KAUR (NP)
Entity Type:Individual
Prefix:
First Name:GURPREET
Middle Name:KAUR
Last Name:TIWANA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11783 CONNECTICUT DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8254
Mailing Address - Country:US
Mailing Address - Phone:171-494-8393
Mailing Address - Fax:
Practice Address - Street 1:11783 CONNECTICUT DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8254
Practice Address - Country:US
Practice Address - Phone:714-948-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA95017157363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner