Provider Demographics
NPI:1356975676
Name:PUREWAL, BALVEEN KAUR (ARNP)
Entity type:Individual
Prefix:
First Name:BALVEEN
Middle Name:KAUR
Last Name:PUREWAL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22022 100TH CT SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2537
Mailing Address - Country:US
Mailing Address - Phone:206-816-4567
Mailing Address - Fax:
Practice Address - Street 1:55 S RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-7100
Practice Address - Country:US
Practice Address - Phone:626-570-8005
Practice Address - Fax:626-570-5639
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95332062163W00000X
WARN6049588163W00000X
WAAP61082245363L00000X
CA95026668363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse