Basic Information
Provider Information
NPI: 1568135366
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATTH
FirstName: GURSIMRAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3834 ADAMS ST
Address2:  
City: TURLOCK
State: CA
PostalCode: 953828827
CountryCode: US
TelephoneNumber: 2094856856
FaxNumber:  
Practice Location
Address1: 7471 N FRESNO ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937202457
CountryCode: US
TelephoneNumber: 5594364500
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/28/2021
LastUpdateDate: 07/28/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95017681CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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