Healthcare Provider Details
I. General information
NPI: 1790169498
Provider Name (Legal Business Name): NORMA MEJIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2015
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8787 HALL RD
LAMONT CA
93241
US
IV. Provider business mailing address
PO BOX 1559
BAKERSFIELD CA
93302-1559
US
V. Phone/Fax
- Phone: 661-845-3731
- Fax: 661-845-1157
- Phone: 661-635-3050
- Fax: 661-635-3070
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | NP95002656 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: