Healthcare Provider Details

I. General information

NPI: 1619898061
Provider Name (Legal Business Name): SARA ELIZABETH CRAWFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18535 BELMONT CIR
ATHENS AL
35613-8605
US

IV. Provider business mailing address

18535 BELMONT CIR
ATHENS AL
35613-8605
US

V. Phone/Fax

Practice location:
  • Phone: 205-807-3852
  • Fax:
Mailing address:
  • Phone: 205-807-3852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-181751
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: