Provider Demographics
NPI:1154815397
Name:CROXTON, TINA MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:MARIE
Last Name:CROXTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:MINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3715 COLUMBUS STREET
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306
Mailing Address - Country:US
Mailing Address - Phone:661-868-7178
Mailing Address - Fax:661-868-7171
Practice Address - Street 1:3715 COLUMBUS STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306
Practice Address - Country:US
Practice Address - Phone:661-868-7178
Practice Address - Fax:661-868-7171
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503528163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse