Healthcare Provider Details

I. General information

NPI: 1336925254
Provider Name (Legal Business Name): KRISTEN EILEEN ANUCHA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 SAN DIMAS ST STE 104
BAKERSFIELD CA
93301-5711
US

IV. Provider business mailing address

11307 FULBOURNE DR
BAKERSFIELD CA
93312-7002
US

V. Phone/Fax

Practice location:
  • Phone: 661-637-1006
  • Fax: 661-637-1020
Mailing address:
  • Phone: 610-733-8175
  • Fax: 661-637-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95026930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: