MEDICARE: COURTNEY CRIPPS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	367500000X	Certified Registered Nurse Anesthetist	1217121	TX
3	367500000X	Certified Registered Nurse Anesthetist	0024187290	VA

General Provider Information

NPI Number	:	1265133854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CRIPPS

Provider Business Mailing Address
First Line	:	953 WILDWOOD SQUARE CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3551
Country	:	US
Telephone Number	:	757-343-7719
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 GRESHAM DR
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-1904
Country	:	US
Telephone Number	:	757-388-3000
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	03/05/2026

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Directions to “ COURTNEY CRIPPS ” Practice Location

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