Provider Demographics
NPI:1366828840
Name:MAGUGAT, ANN MICHELLE ROQUE (NP-C)
Entity Type:Individual
Prefix:
First Name:ANN MICHELLE
Middle Name:ROQUE
Last Name:MAGUGAT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OLD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9781
Mailing Address - Country:US
Mailing Address - Phone:661-663-6275
Mailing Address - Fax:
Practice Address - Street 1:1919 HOLT RINEHART AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1746
Practice Address - Country:US
Practice Address - Phone:661-331-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily