=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306448089
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN CRAWFORD NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2020
-----------------------------------------------------
Last Update Date | 04/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 CAPITAL WAY STE 456
-----------------------------------------------------
City | PENNINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08534-2521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-537-7300
-----------------------------------------------------
Fax | 609-537-7301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 790 HIGHPOINTE CIR
-----------------------------------------------------
City | LANGHORNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19047-5161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-468-7949
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ01100100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------