Basic Information
| Provider Information | |||||||||
| NPI: | 1679008551 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKHURST | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4900 CALIFORNIA AVE | ||||||||
| Address2: | SUITE 400B | ||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933097024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6614591900 | ||||||||
| FaxNumber: | 6614591974 | ||||||||
| Practice Location | |||||||||
| Address1: | 1133 CHELSEA ST | ||||||||
| Address2: | |||||||||
| City: | RIDGECREST | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935553208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003006664 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2017 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 160575 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.