Healthcare Provider Details

I. General information

NPI: 1184009276
Provider Name (Legal Business Name): ERICA ASHLEY CRAWFORD MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 FOREST PARK AVE PLANNED PARENTHOOD
SAINT LOUIS MO
63108
US

IV. Provider business mailing address

3017 CAROLINE ST
SAINT LOUIS MO
63104-1804
US

V. Phone/Fax

Practice location:
  • Phone: 314-531-7526
  • Fax:
Mailing address:
  • Phone: 314-783-6140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015011091
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: