Provider Demographics
NPI:1659142610
Name:LINA, ABIGAIL ALFONSO (MSN, FNP-BC, PHN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ALFONSO
Last Name:LINA
Suffix:
Gender:F
Credentials:MSN, FNP-BC, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2818
Mailing Address - Country:US
Mailing Address - Phone:661-633-5266
Mailing Address - Fax:909-494-7549
Practice Address - Street 1:2500 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2818
Practice Address - Country:US
Practice Address - Phone:661-633-5266
Practice Address - Fax:909-494-7549
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95173921163W00000X
CA95026195363L00000X, 363LF0000X
CA556747363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health