Healthcare Provider Details

I. General information

NPI: 1629554043
Provider Name (Legal Business Name): ELIZABETH K CRUMPTON APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 HELEN HWY
CLEVELAND GA
30528-7804
US

IV. Provider business mailing address

PO BOX 496 84 HELEN HIGHWAY
CLEVELAND GA
30528-0009
US

V. Phone/Fax

Practice location:
  • Phone: 706-219-2273
  • Fax:
Mailing address:
  • Phone: 770-519-1900
  • Fax: 706-865-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32449
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP112053
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: