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General NPI Number Information
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NPI Number | 1134351299
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Entity Type | Individual
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Provider Name | BRANDY RENAE CRUMP APN
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Gender | Female
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 1111 WINDOVER RD
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City | JONESBORO
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State | AR
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Zip | 72401-6159
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Country | US
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Telephone | 870-935-5432
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Fax | 870-935-4887
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Provider Business Mailing Address
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Address Line | 1111 WINDOVER RD
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City | JONESBORO
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State | AR
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Zip | 72401-6159
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Country | US
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Telephone | 870-935-5432
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Fax | 870-935-4887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A03284
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License Number State | AR
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