Doctor Name: | CAROLYN DOHME CRUMPLER |
NPI Number: | 1063841039 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 221042 |
Business Practice Address: | 260 Elm St Cumming, GA - 300402467 |
Business Phone Number: | 7708871668 |
Business Fax Number: | 7707819937 |
Mailing Address: | Po Box 307, CUMMING |
State: | GA |
Postal Code: | 300280307 |
Phone Number: | 7708871668 |
Fax Number: | 7707819937 |
NPI Enumeration Date: | 11/11/2013 |
NPI Last Update Date: | 11/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 221042 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |