NPI | 1902812530 |
---|---|
Former Name | MISTY EVAGENE CRAWFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN081564) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: AZ RN081564) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2017-02-10 |