Individual
JOHNETTA NICOLE MACKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1010 1/2 S UNION AVE, BAKERSFIELD, CA 93307-3642
(661) 321-0234
Mailing address
5505 ROCKVIEW DR, BAKERSFIELD, CA 93313-5224
(661) 321-0234
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
733072
CA
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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