Doctor Name: | AUDREY CRANDALL |
NPI Number: | 1124374350 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | 13593 |
Business Practice Address: | 1426 Scott St Napoleon, OH - 435451026 |
Business Phone Number: | 4195995600 |
Business Fax Number: | 4195667834 |
Mailing Address: | 2200 Jefferson Ave, 5th Fl TOLEDO |
State: | OH |
Postal Code: | 436047101 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/25/2012 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 13593 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |