MEDICARE: KRISTI EVE 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	363LF0000X	Family Nurse Practitioner	11023914	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144934357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI EVE CRAWFORD

Provider Business Mailing Address
First Line	:	179 MACK BAYOU LOOP STE 201
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-7210
Country	:	US
Telephone Number	:	850-278-3920
Fax Number	:	850-278-3919

Provider Business Practice Location Address
First Line	:	179 MACK BAYOU LOOP STE 201
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-7210
Country	:	US
Telephone Number	:	850-233-6922
Fax Number	:

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

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	12/12/2024

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Directions to “ KRISTI EVE CRAWFORD ” Practice Location

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