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General NPI Number Information
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NPI Number | 1184908733
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Entity Type | Individual
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Provider Name | KIMBERLY NICHOL CRABAUGH
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Gender | Female
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 6551 MCCARRAN ST #3031
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1435
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Country | US
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Telephone | 909-525-6245
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Fax |
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Provider Business Mailing Address
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Address Line | 6551 MCCARRAN ST #3031
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1435
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Country | US
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Telephone | 909-525-6245
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Fax |
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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