Healthcare Provider Details

I. General information

NPI: 1669843439
Provider Name (Legal Business Name): ALESHIA CRUMP MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 04/20/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 GARRETT RD
DREXEL HILL PA
19026-2217
US

IV. Provider business mailing address

3030 GARRETT RD
DREXEL HILL PA
19026-2217
US

V. Phone/Fax

Practice location:
  • Phone: 610-622-7933
  • Fax: 610-622-7937
Mailing address:
  • Phone: 610-622-7933
  • Fax: 610-622-7937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011730
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015264
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0067573
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: