Healthcare Provider Details

I. General information

NPI: 1760874952
Provider Name (Legal Business Name): KASSIE M. CRABTREE APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KASSIE M. BRITTON FNP-C

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 HIGHWAY 28 STE 200
JASPER TN
37347-3744
US

IV. Provider business mailing address

980 HIGHWAY 28 STE 200
JASPER TN
37347-3744
US

V. Phone/Fax

Practice location:
  • Phone: 423-942-3869
  • Fax: 423-942-2472
Mailing address:
  • Phone: 423-942-3869
  • Fax: 423-778-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number000000
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19908
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: