Provider Demographics
NPI:1871041970
Name:NIJJAR, NISHA S (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:NISHA
Middle Name:S
Last Name:NIJJAR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 E ROSEVILLE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3303
Mailing Address - Country:US
Mailing Address - Phone:916-783-7109
Mailing Address - Fax:
Practice Address - Street 1:1620 E ROSEVILLE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3303
Practice Address - Country:US
Practice Address - Phone:916-783-7109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily