Healthcare Provider Details

I. General information

NPI: 1801077961
Provider Name (Legal Business Name): LAURA JOSEPHINA HASTING R.N., NP., P.H.N,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 CALIFORNIA AVE
BAKERSFIELD CA
93309-1104
US

IV. Provider business mailing address

4580 CALIFORNIA AVE
BAKERSFIELD CA
93309-1104
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4411
  • Fax: 661-846-4859
Mailing address:
  • Phone: 661-327-4411
  • Fax: 661-846-4859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19672
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number713092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: