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General NPI Number Information
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NPI Number | 1518374024
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Entity Type | Organization
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Legal Business Name | MANDY CRAWFORD FAMILY PRACTICE PLC
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 2315 MAYFAIR DR SUITE 16
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City | OWENSBORO
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State | KY
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Zip | 42301-4557
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Country | US
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Telephone | 270-478-4963
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Fax | 270-478-4965
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Provider Business Mailing Address
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Address Line | 2315 MAYFAIR DR SUITE 16
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City | OWENSBORO
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State | KY
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Zip | 42301-4557
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Country | US
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Telephone | 270-478-4963
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Fax | 270-478-4965
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | AMANDA CRAWFORD
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Credential | APRN
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Telephone | 270-478-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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