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NPI Code Detail

MEDICARE: LUCY CRUMP FNP

MEDICARE: LUCY CRUMP FNP
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
1363L00000XNurse Practitioner5010772NC
2363LF0000XFamily Nurse Practitioner5010772NC

General Provider Information

NPI Number : 1487131496
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCY CRUMP FNP
Provider Business Mailing Address
First Line : PO BOX 19305
Second Line :
City : CHARLOTTE
State : NC
Zip : 28219-9305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 269 S MAIN ST
Second Line :
City : NORWOOD
State : NC
Zip : 28128-6435
Country : US
Telephone Number : 980-323-5470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2018
Last Update Date : 07/15/2024

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