Provider Demographics
NPI:1710500368
Name:ATWAL, PARMINDER KAUR
Entity type:Individual
Prefix:
First Name:PARMINDER
Middle Name:KAUR
Last Name:ATWAL
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 1:5524 SPRING FLOWER DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-8331
Mailing Address - Country:US
Mailing Address - Phone:916-320-7381
Mailing Address - Fax:
Practice Address - Street 1:4433 FLORIN RD # 600
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2527
Practice Address - Country:US
Practice Address - Phone:916-320-7381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA203035164X00000X
CA95398207164X00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse