Healthcare Provider Details

I. General information

NPI: 1013198969
Provider Name (Legal Business Name): ELAINE RUTH ANTHONY RN PHN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MOUNT VERNON AVE
BAKERSFIELD CA
93306-3302
US

IV. Provider business mailing address

1800 MOUNT VERNON AVE
BAKERSFIELD CA
93306-3302
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-0502
  • Fax: 661-868-0218
Mailing address:
  • Phone: 661-746-7562
  • Fax: 661-746-7591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number536556
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: