Healthcare Provider Details

I. General information

NPI: 1841234051
Provider Name (Legal Business Name): CHRISTIE JILL CROFT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9064 US HWY 60 W
STURGIS KY
42459
US

IV. Provider business mailing address

PO BOX 1079
HENDERSON KY
42419-1079
US

V. Phone/Fax

Practice location:
  • Phone: 270-333-4349
  • Fax: 270-333-9292
Mailing address:
  • Phone: 270-827-0353
  • Fax: 270-827-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3004847
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004847
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: