Healthcare Provider Details

I. General information

NPI: 1598475303
Provider Name (Legal Business Name): KAREN STONES CRAWFORD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14283 S BLACK WULFF DR APT SUITE
BLUFFDALE UT
84065-3806
US

IV. Provider business mailing address

14283 S BLACK WULFF DR APT SUITE
BLUFFDALE UT
84065-3806
US

V. Phone/Fax

Practice location:
  • Phone: 801-380-0444
  • Fax:
Mailing address:
  • Phone: 801-380-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number303971-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: