Provider Demographics
NPI:1952833394
Name:BAJWA, KULWINDER NICOLE (CNM, APRN)
Entity Type:Individual
Prefix:MRS
First Name:KULWINDER
Middle Name:NICOLE
Last Name:BAJWA
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 BARTLETT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-8216
Mailing Address - Country:US
Mailing Address - Phone:203-779-5215
Mailing Address - Fax:
Practice Address - Street 1:1075 ASYLUM AVE FL 1
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2455
Practice Address - Country:US
Practice Address - Phone:860-714-4457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6996363LW0102X
CT418367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health