Healthcare Provider Details

I. General information

NPI: 1467287664
Provider Name (Legal Business Name): ANTHONIA NKIRUKA OKOYEUZU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SILLECT AVE
BAKERSFIELD CA
93308-6340
US

IV. Provider business mailing address

12315 RUBY RIVER DR
BAKERSFIELD CA
93312-6852
US

V. Phone/Fax

Practice location:
  • Phone: 562-215-1137
  • Fax:
Mailing address:
  • Phone: 562-215-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95031878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: