Healthcare Provider Details

I. General information

NPI: 1740843671
Provider Name (Legal Business Name): BRITTANY NICOLE CRABTREE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WASHINGTON ST W
CHARLESTON WV
25302-2344
US

IV. Provider business mailing address

108 WASHINGTON ST W STE 101
CHARLESTON WV
25302-2344
US

V. Phone/Fax

Practice location:
  • Phone: 304-345-4525
  • Fax: 304-388-2437
Mailing address:
  • Phone: 304-345-4525
  • Fax: 304-345-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number32483
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: