Provider Demographics
NPI:1255716783
Name:KAUR, BALJINDER (FNP- BC, PMHNP- BC)
Entity type:Individual
Prefix:
First Name:BALJINDER
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:FNP- BC, PMHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 E BASELINE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-9630
Mailing Address - Country:US
Mailing Address - Phone:602-323-3000
Mailing Address - Fax:602-243-5390
Practice Address - Street 1:3540 E BASELINE RD STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-9630
Practice Address - Country:US
Practice Address - Phone:602-323-3000
Practice Address - Fax:602-243-5390
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ259185363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100048464Medicaid
WI6042079OtherCIGNA
WI6042079OtherCIGNA