Provider Demographics
NPI:1710761085
Name:GREWAL, AMANPREET KAUR (FNP)
Entity Type:Individual
Prefix:
First Name:AMANPREET
Middle Name:KAUR
Last Name:GREWAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-4301
Mailing Address - Country:US
Mailing Address - Phone:559-439-3000
Mailing Address - Fax:559-439-3004
Practice Address - Street 1:6730 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-4301
Practice Address - Country:US
Practice Address - Phone:559-439-3000
Practice Address - Fax:559-439-3004
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily