Provider Demographics
NPI:1295308740
Name:KAUR, GAGANDEEP
Entity type:Individual
Prefix:
First Name:GAGANDEEP
Middle Name:
Last Name:KAUR
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 1:1235 E ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-2024
Mailing Address - Country:US
Mailing Address - Phone:559-268-6261
Mailing Address - Fax:
Practice Address - Street 1:3103 E CARTWRIGHT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93725-9385
Practice Address - Country:US
Practice Address - Phone:559-498-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN274873164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse