Provider Demographics
NPI:1932775079
Name:KAUR, AMANDEEP (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3926 STONINGTON CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-8990
Mailing Address - Country:US
Mailing Address - Phone:707-319-1894
Mailing Address - Fax:
Practice Address - Street 1:3926 STONINGTON CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-8990
Practice Address - Country:US
Practice Address - Phone:707-319-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily