Provider Demographics
NPI:1881305209
Name:KAUR, AMRIT (RN)
Entity type:Individual
Prefix:
First Name:AMRIT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 EUCALYPTUS ST STE A
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-4317
Mailing Address - Country:US
Mailing Address - Phone:209-284-4561
Mailing Address - Fax:
Practice Address - Street 1:1079 EUCALYPTUS ST STE A
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4317
Practice Address - Country:US
Practice Address - Phone:209-284-4561
Practice Address - Fax:209-284-4562
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95240944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95240944OtherCALIFORNIA STATE LICENSE