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General NPI Number Information
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NPI Number | 1205719770
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Entity Type | Individual
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Provider Name | MRS. TONYA LEE CRUM
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 555 MAIN STREET
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City | CHAPMANVILLE
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State | WV
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Zip | 25508
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Country | US
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Telephone | 304-688-9901
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Fax | 304-688-9904
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Provider Business Mailing Address
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Address Line | PO BOX 1637
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City | CHAPMANVILLE
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State | WV
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Zip | 25508-1637
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Country | US
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Telephone | 304-688-9901
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Fax | 304-688-9904
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 123976
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License Number State | WV
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