Provider Demographics
NPI:1578061891
Name:BUENROSTRO, NORMA ALICIA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:ALICIA
Last Name:BUENROSTRO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:ALICIA
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5009 CLEAR CRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-5651
Mailing Address - Country:US
Mailing Address - Phone:661-858-3322
Mailing Address - Fax:661-412-4017
Practice Address - Street 1:501 MUNZER ST STE C
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263-2042
Practice Address - Country:US
Practice Address - Phone:661-630-5274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95008315363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care