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General NPI Number Information
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NPI Number | 1477290526
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Entity Type | Individual
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Provider Name | KRISTEN MICHELE CROCKER
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 9576 S US HIGHWAY 1
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-4217
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Country | US
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Telephone | 772-337-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1746 HIGHLAND DR SW
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City | VERO BEACH
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State | FL
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Zip | 32962-6948
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Country | US
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Telephone | 210-326-3119
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRN11019200
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | RN9385303
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License Number State | NC
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