Healthcare Provider Details

I. General information

NPI: 1437367133
Provider Name (Legal Business Name): DESTINY JANELL CROMER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESTINY JANELL TRAPHOFNER NP

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 BREVARD RD
ASHEVILLE NC
28806-2316
US

IV. Provider business mailing address

172 BRANNON FOREST DR
WAYNESVILLE NC
28785-7235
US

V. Phone/Fax

Practice location:
  • Phone: 828-212-7021
  • Fax: 828-232-8218
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011253
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5011253.
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP120104
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: