Healthcare Provider Details

I. General information

NPI: 1568754851
Provider Name (Legal Business Name): JO A CRABTREE MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HALS PLZ STE A
PIEDMONT MO
63957-1631
US

IV. Provider business mailing address

110 S 2ND ST
ELLINGTON MO
63638-9400
US

V. Phone/Fax

Practice location:
  • Phone: 573-223-4800
  • Fax: 573-223-7911
Mailing address:
  • Phone: 573-663-2313
  • Fax: 573-663-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2011012312
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: