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General NPI Number Information
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NPI Number | 1205507589
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Entity Type | Individual
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Provider Name | AUTUMN ELIZABETH CRISP CNP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 75 ARCH ST STE B1
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City | AKRON
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State | OH
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Zip | 44304-1474
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Country | US
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Telephone | 330-375-4844
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Fax | 330-375-4067
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Provider Business Mailing Address
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Address Line | 29054 SW MEEK LOOP APT 248
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City | WILSONVILLE
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State | OR
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Zip | 97070-6512
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Country | US
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Telephone | 216-466-2424
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95020313
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 0029806
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | APRN.CNP.0029806
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License Number State | OH
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