Provider Demographics
NPI:1689200313
Name:LUNDIN-CRITTENDEN, ROXANNE (RN, CNM)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:LUNDIN-CRITTENDEN
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:CRITTENDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CNM
Mailing Address - Street 1:2809 OLIVE HWY STE 320
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6135
Mailing Address - Country:US
Mailing Address - Phone:530-532-8440
Mailing Address - Fax:
Practice Address - Street 1:2809 OLIVE HWY STE 320
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6135
Practice Address - Country:US
Practice Address - Phone:530-532-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236112367A00000X
CA95196419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse