Provider Demographics
NPI:1689853673
Name:CROTTEAU, MICHELE ANN (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANN
Last Name:CROTTEAU
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:CROTTEAU
Other - Last Name:SOLAKIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 BRUNDAGE LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-3248
Mailing Address - Country:US
Mailing Address - Phone:661-323-6086
Mailing Address - Fax:661-324-6301
Practice Address - Street 1:301 BRUNDAGE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-3248
Practice Address - Country:US
Practice Address - Phone:661-323-6086
Practice Address - Fax:661-324-6301
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10176363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care