Provider Demographics
NPI:1295867372
Name:MORALES, CARMEN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-1144
Mailing Address - Country:US
Mailing Address - Phone:661-871-9674
Mailing Address - Fax:661-873-7655
Practice Address - Street 1:1830 FLOWER ST
Practice Address - Street 2:ROOM 1021
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4144
Practice Address - Country:US
Practice Address - Phone:661-326-5600
Practice Address - Fax:661-326-2790
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 13878363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care