Healthcare Provider Details

I. General information

NPI: 1578045902
Provider Name (Legal Business Name): MICHELLE ANN HULES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2018
Last Update Date: 09/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 CALIFORNIA AVE
BAKERSFIELD CA
93309
US

IV. Provider business mailing address

3719 COLLINGWOOD DR
BAKERSFIELD CA
93311
US

V. Phone/Fax

Practice location:
  • Phone: 661-208-4648
  • Fax:
Mailing address:
  • Phone: 818-282-0756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: