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NPI Code Detail

MEDICARE: BRANDY CRUM

MEDICARE: BRANDY CRUM
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376407551
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY CRUM
Provider Business Mailing Address
First Line : 1751 WOODLAND ST NE
Second Line :
City : WARREN
State : OH
Zip : 44483-5303
Country : US
Telephone Number : 330-770-2850
Fax Number :
Provider Business Practice Location Address
First Line : 165 E PARK AVE
Second Line :
City : NILES
State : OH
Zip : 44446-2352
Country : US
Telephone Number : 330-544-8005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ BRANDY CRUM ” Practice Location

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