Healthcare Provider Details

I. General information

NPI: 1255741906
Provider Name (Legal Business Name): KRISTY DOTY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2014
Last Update Date: 10/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 34TH ST
BAKERSFIELD CA
93301-2237
US

IV. Provider business mailing address

416 HILLARD ST
TAFT CA
93268-2600
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4647
  • Fax:
Mailing address:
  • Phone: 661-623-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number684863
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: