Healthcare Provider Details

I. General information

NPI: 1366414302
Provider Name (Legal Business Name): NANCY DUPLAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20960 A SAGE LN
TEHACHAPI CA
93561
US

IV. Provider business mailing address

PO BOX 2029
BAKERSFIELD CA
93303
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-2890
  • Fax: 661-822-2891
Mailing address:
  • Phone: 661-335-7755
  • Fax: 661-335-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2516350NA786
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: