Healthcare Provider Details

I. General information

NPI: 1659142610
Provider Name (Legal Business Name): ABIGAIL ALFONSO LINA MSN, FNP-BC, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 H ST
BAKERSFIELD CA
93301-2818
US

IV. Provider business mailing address

2500 H ST
BAKERSFIELD CA
93301-2818
US

V. Phone/Fax

Practice location:
  • Phone: 661-633-5266
  • Fax: 909-494-7549
Mailing address:
  • Phone: 661-633-5266
  • Fax: 909-494-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95026195
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number556747
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026195
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95173921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: