Provider Demographics
NPI:1689253635
Name:NAGRA, KIRANPREET KAUR
Entity Type:Individual
Prefix:
First Name:KIRANPREET
Middle Name:KAUR
Last Name:NAGRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 CASTERBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-4907
Mailing Address - Country:US
Mailing Address - Phone:916-749-8415
Mailing Address - Fax:
Practice Address - Street 1:1861 CASTERBRIDGE DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-4907
Practice Address - Country:US
Practice Address - Phone:916-749-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program