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NPI 1780132241

NPI 1780132241 : CRYSTAL JOHNSON CRUTCHFIELD FNP : HICKORY, NC

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General NPI Number Information
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    NPI Number           |    1780132241
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    Entity Type          |    Individual 
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    Provider Name        |    CRYSTAL JOHNSON CRUTCHFIELD FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/13/2016
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    Last Update Date     |    09/13/2016
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Provider Practice Location Address
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    Address Line         |    810 FAIRGROVE CHURCH RD 
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    City                 |    HICKORY
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    State                |    NC
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    Zip                  |    28602-9617
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    Country              |    US
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    Telephone            |    828-326-3855
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    Fax                  |    828-326-2717
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Provider Business Mailing Address
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    Address Line         |    6031 HICKORY LINCOLNTON HWY 
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    City                 |    LINCOLNTON
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    State                |    NC
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    Zip                  |    28092-6819
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    Country              |    US
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    Telephone            |    704-473-6429
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    5008908
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    License Number State |    NC
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