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General NPI Number Information
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NPI Number | 1568084242
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Entity Type | Individual
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Provider Name | LISA EDWARDS CRUMPTON FNP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 5915 CARMICHAEL RD
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City | MONTGOMERY
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State | AL
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Zip | 36117-2507
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Country | US
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Telephone | 334-245-8736
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Fax | 334-245-1771
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Provider Business Mailing Address
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Address Line | 220 COUNTY ROAD 911
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City | ORRVILLE
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State | AL
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Zip | 36767-2710
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Country | US
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Telephone | 334-996-8128
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-049552
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License Number State | AL
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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 | 1-049552
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License Number State | AL
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