Provider Demographics
NPI:1053902130
Name:THIND, SIMRANJOT KAUR
Entity type:Individual
Prefix:
First Name:SIMRANJOT
Middle Name:KAUR
Last Name:THIND
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 1:31292 ALPINE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:SHINGLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:96088-9462
Mailing Address - Country:US
Mailing Address - Phone:530-474-3390
Mailing Address - Fax:530-474-4899
Practice Address - Street 1:31292 ALPINE MEADOWS RD
Practice Address - Street 2:
Practice Address - City:SHINGLETOWN
Practice Address - State:CA
Practice Address - Zip Code:96088-9462
Practice Address - Country:US
Practice Address - Phone:530-474-3390
Practice Address - Fax:530-474-4899
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017366363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty