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General NPI Number Information
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NPI Number | 1366828840
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Entity Type | Individual
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Provider Name | ANN MICHELLE ROQUE MAGUGAT NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 1919 HOLT RINEHART AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1746
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Country | US
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Telephone | 661-331-9216
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Fax |
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Provider Business Mailing Address
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Address Line | 400 OLD RIVER RD
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9781
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Country | US
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Telephone | 661-663-6275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95003215
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License Number State | CA
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