Healthcare Provider Details

I. General information

NPI: 1174432041
Provider Name (Legal Business Name): LACEY CRAWFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL CIR STE A
BATESVILLE AR
72501-7343
US

IV. Provider business mailing address

16 HOSPITAL CIR STE A
BATESVILLE AR
72501-7343
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-7519
  • Fax:
Mailing address:
  • Phone: 870-793-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number239401
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: