Healthcare Provider Details

I. General information

NPI: 1760974018
Provider Name (Legal Business Name): MRS. GINGER CARMICHAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINGER PERKINS RN

II. Dates (important events)

Enumeration Date: 06/02/2018
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 E CHURCH ST STE 301
SANTA MARIA CA
93454-5915
US

IV. Provider business mailing address

1325 E CHURCH ST STE 301
SANTA MARIA CA
93454-5915
US

V. Phone/Fax

Practice location:
  • Phone: 805-349-9393
  • Fax:
Mailing address:
  • Phone: 805-349-9393
  • Fax: 805-614-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN.0160642
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0994071-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95016420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: