{
"Npi": {
"NPI": "1831354109",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CRAWFORD",
"FirstName": "COLLEEN",
"MiddleName": "M.",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PHYSICIAN ASSISTANT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "FINEGAN",
"OtherFirstName": "COLLEEN",
"OtherMiddleName": "M.",
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "PHYSICIAN ASSISTANT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 95590",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH JORDAN",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84095-0590",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-352-9500",
"MailingAddressFaxNumber": "801-352-7976",
"FirstLinePracticeLocationAddress": "125 BAPTIST WAY STE 4C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PENSACOLA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32503-2274",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "448-227-6330",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/25/2008",
"LastUpdateDate": "02/23/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "PA.1381",
"LicenseNumberStateCode": "AL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "PA9107885",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}