Individual
MIKI DEANNA BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4821 PANAMA LN, BAKERSFIELD, CA 93313-3480
(661) 556-4777
Mailing address
4821 PANAMA LN, BAKERSFIELD, CA 93313-3480
(310) 809-9632
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95024668
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/29/2022
Last updated
05/25/2023
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