Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 95013424 | CA |
NPI | 1013558089 |
---|---|
Provider Name | Monette Hoburn |
First Address | Bakersfield, CA 93305-1937 |
Second Address | Bakersfield, CA 93305-1936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2019 |
Last Update Date | 08/09/2020 |