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NPI Code Detail

MEDICARE: AMY NICOLE CRAWFORD

MEDICARE:   AMY NICOLE 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
1175T00000XPeer SpecialistOK

General Provider Information

NPI Number : 1255193942
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY NICOLE CRAWFORD
Provider Business Mailing Address
First Line : 5016 N WARREN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-2235
Country : US
Telephone Number : 572-206-7005
Fax Number :
Provider Business Practice Location Address
First Line : 5016 N WARREN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-2235
Country : US
Telephone Number : 572-206-7005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2024
Last Update Date : 01/29/2024

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Directions to “ AMY NICOLE CRAWFORD ” Practice Location

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