Healthcare Provider Details

I. General information

NPI: 1295570141
Provider Name (Legal Business Name): ANDREA CRIGGER AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 FOX FIRE RD
MAX MEADOWS VA
24360
US

IV. Provider business mailing address

450 W MONROE ST
WYTHEVILLE VA
24382-2236
US

V. Phone/Fax

Practice location:
  • Phone: 276-920-7793
  • Fax:
Mailing address:
  • Phone: 276-223-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024190601
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024190601
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: