Healthcare Provider Details

I. General information

NPI: 1902449465
Provider Name (Legal Business Name): HANNA GAYLE CRAWFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 ALCOA HWY STE 330
KNOXVILLE TN
37920-1547
US

IV. Provider business mailing address

1926 ALCOA HWY STE 330
KNOXVILLE TN
37920-1547
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9218
  • Fax: 865-305-8262
Mailing address:
  • Phone: 865-305-9218
  • Fax: 865-305-8262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26088
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: