Healthcare Provider Details

I. General information

NPI: 1891273421
Provider Name (Legal Business Name): CHRISTIE DAWN HEBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 ASHE RD
BAKERSFIELD CA
93313-2029
US

IV. Provider business mailing address

4200 ASHE RD
BAKERSFIELD CA
93313-2029
US

V. Phone/Fax

Practice location:
  • Phone: 661-831-8331
  • Fax:
Mailing address:
  • Phone: 661-831-8331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number517259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: