Provider Demographics
NPI:1457902017
Name:PURI, PARUL (FNP-BC, DNP)
Entity Type:Individual
Prefix:
First Name:PARUL
Middle Name:
Last Name:PURI
Suffix:
Gender:F
Credentials:FNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 RIVER PARK DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4500
Mailing Address - Country:US
Mailing Address - Phone:916-925-7020
Mailing Address - Fax:
Practice Address - Street 1:1495 RIVER PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4517
Practice Address - Country:US
Practice Address - Phone:916-925-7020
Practice Address - Fax:916-925-3680
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily