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NPI Code Detail

MEDICARE: STACEY ANN CRAWFORD LLC

MEDICARE: STACEY ANN CRAWFORD LLC
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
1311ZA0620XAdult Care Home Facility

General Provider Information

NPI Number : 1215886593
Entity Type Code : Organization
Provider Name (Legal Business Name) : STACEY ANN CRAWFORD LLC
Provider Business Mailing Address
First Line : 9771 PARKER LAKE CIR
Second Line :
City : NAVARRE
State : FL
Zip : 32566-4806
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9771 PARKER LAKE CIR
Second Line :
City : NAVARRE
State : FL
Zip : 32566-4806
Country : US
Telephone Number : 850-200-5792
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : STACEY ANN CRAWFORD
Credential :
Telephone Number : 850-200-5792
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

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Directions to “STACEY ANN CRAWFORD LLC ” Practice Location

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