Provider Demographics
NPI:1154364123
Name:KAUR, BALWINDER (NP)
Entity type:Individual
Prefix:MS
First Name:BALWINDER
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 PINEHIGH CT
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-7060
Mailing Address - Country:US
Mailing Address - Phone:770-449-3251
Mailing Address - Fax:
Practice Address - Street 1:5985 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2818
Practice Address - Country:US
Practice Address - Phone:770-449-0990
Practice Address - Fax:770-448-8818
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN141621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP31995Medicare UPIN