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General NPI Number Information
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NPI Number | 1811274327
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Entity Type | Individual
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Provider Name | LINDSAY BROOKE WILSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 2000 PHYSICIANS BLVD SUITE 300
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1277
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Country | US
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Telephone | 661-324-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 TRUXTUN AVE SUITE 400
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City | BAKERSFIELD
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State | CA
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Zip | 93301-5246
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Country | US
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Telephone | 661-635-3050
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Fax | 661-326-1347
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 706754
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 20821
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License Number State | CA
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