MEDICARE: ASHLIN CRAWFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	228990	AR

General Provider Information

NPI Number	:	1083458665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLIN CRAWFORD

Provider Business Mailing Address
First Line	:	4121 KINGS RIVER TRL
Second Line	:
City	:	BAUXITE
State	:	AR
Zip	:	72011-5017
Country	:	US
Telephone Number	:	870-740-5708
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 KINGS RIVER TRL
Second Line	:
City	:	BAUXITE
State	:	AR
Zip	:	72011-5017
Country	:	US
Telephone Number	:	870-740-5708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	06/19/2024

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Directions to “ ASHLIN CRAWFORD ” Practice Location

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