Provider Demographics
NPI:1134355993
Name:CRADDOCK, CHRISTINE ARBUTHNOT (CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ARBUTHNOT
Last Name:CRADDOCK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 HEATHER PL
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1435
Mailing Address - Country:US
Mailing Address - Phone:949-494-1553
Mailing Address - Fax:949-494-1553
Practice Address - Street 1:345 HEATHER PL
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1435
Practice Address - Country:US
Practice Address - Phone:949-494-1553
Practice Address - Fax:949-494-1553
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA431367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered