Healthcare Provider Details

I. General information

NPI: 1528193547
Provider Name (Legal Business Name): ELIZABETH JARMAN CRAWLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 SMITH CHURCH RD
ROANOKE RAPIDS NC
27870-4914
US

IV. Provider business mailing address

400 DRUMGOLD RD
LITTLETON NC
27850-9253
US

V. Phone/Fax

Practice location:
  • Phone: 252-535-8185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number054457
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: