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NPI Code Detail

MEDICARE: MRS. AMANDA MICHELLE CRUMPLER

MEDICARE: MRS. AMANDA MICHELLE CRUMPLER
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
1164W00000XLicensed Practical Nurse0002092777VA

General Provider Information

NPI Number : 1982317319
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA MICHELLE CRUMPLER
Provider Business Mailing Address
First Line : 2869 SENECA TRL S
Second Line :
City : PETERSTOWN
State : WV
Zip : 24963-5037
Country : US
Telephone Number : 304-753-4336
Fax Number : 304-753-4097
Provider Business Practice Location Address
First Line : 2869 SENECA TRL S
Second Line :
City : PETERSTOWN
State : WV
Zip : 24963-5037
Country : US
Telephone Number : 304-753-4336
Fax Number : 304-753-4097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2022
Last Update Date : 12/30/2022

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Directions to “ MRS. AMANDA MICHELLE CRUMPLER ” Practice Location

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