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NPI Code Detail

MEDICARE: NIKKI SUSAN CRAWFORD RN BSN MSHA

MEDICARE: NIKKI SUSAN CRAWFORD RN BSN MSHA
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
1163W00000XRegistered NurseRN588462FL

General Provider Information

NPI Number : 1265406169
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKKI SUSAN CRAWFORD RN BSN MSHA
Provider Business Mailing Address
First Line : 1875 BOGGY CREEK RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-9516
Country : US
Telephone Number : 407-343-2047
Fax Number : 407-343-2042
Provider Business Practice Location Address
First Line : 1875 BOGGY CREEK RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-9516
Country : US
Telephone Number : 407-343-2047
Fax Number : 407-343-2069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 07/08/2007

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