MEDICARE: MRS. MALORIE SUSAN CRAWFORD R.N.C., B.S.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5009140	NC
2	363LW0102X	Women's Health Nurse Practitioner	5009140	NC

General Provider Information

NPI Number	:	1073517041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MALORIE SUSAN CRAWFORD R.N.C., B.S.N.

Provider Business Mailing Address
First Line	:	322 MULBERRY STREET, SW
Second Line	:	SUITE A
City	:	LENOIR
State	:	NC
Zip	:	28645-5703
Country	:	US
Telephone Number	:	828-757-6400
Fax Number	:	828-757-6424

Provider Business Practice Location Address
First Line	:	322 MULBERRY STREET, SW
Second Line	:	SUITE A
City	:	LENOIR
State	:	NC
Zip	:	28645-5703
Country	:	US
Telephone Number	:	828-757-6400
Fax Number	:	828-757-6424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	03/17/2021

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