Provider Demographics
NPI:1457242679
Name:PURBA, MANREET SINGH (DNP FNP-BC)
Entity type:Individual
Prefix:
First Name:MANREET
Middle Name:SINGH
Last Name:PURBA
Suffix:
Gender:M
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N SAMISH WAY UNIT 441
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6087
Mailing Address - Country:US
Mailing Address - Phone:360-296-1785
Mailing Address - Fax:
Practice Address - Street 1:19803 1ST AVE S STE 200
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2410
Practice Address - Country:US
Practice Address - Phone:360-296-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP70021427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily