Doctor Name: | MRS. TRACY CRAWFORD |
NPI Number: | 1063826956 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 18869 |
Business Practice Address: | 24 E Main St Williamston, SC - 296971925 |
Business Phone Number: | 8648476020 |
Business Fax Number: | 8648476007 |
Mailing Address: | 24 E Main St, WILLIAMSTON |
State: | SC |
Postal Code: | 296971925 |
Phone Number: | 8648476020 |
Fax Number: | 8648476007 |
NPI Enumeration Date: | 06/18/2014 |
NPI Last Update Date: | 06/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 18869 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |