Healthcare Provider Details

I. General information

NPI: 1649908666
Provider Name (Legal Business Name): CLAIRE ASHTON CROMER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 3RD AVE NE STE 500
HICKORY NC
28601-5055
US

IV. Provider business mailing address

1527 39TH AVENUE LOOP NE UNIT 4
HICKORY NC
28601-7683
US

V. Phone/Fax

Practice location:
  • Phone: 828-304-6363
  • Fax:
Mailing address:
  • Phone: 260-224-3849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001014404
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: