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NPI Code Detail

MEDICARE: BENJAMIN CRAWFORD RN

MEDICARE: BENJAMIN CRAWFORD RN
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
1163WE0003XEmergency Registered Nurse52389WY

General Provider Information

NPI Number : 1417813247
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN CRAWFORD RN
Provider Business Mailing Address
First Line : 3 PINTO LN
Second Line :
City : LANDER
State : WY
Zip : 82520-9756
Country : US
Telephone Number : 307-335-6390
Fax Number :
Provider Business Practice Location Address
First Line : 1320 BISHOP RANDALL DR
Second Line :
City : LANDER
State : WY
Zip : 82520-3939
Country : US
Telephone Number : 307-335-6395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2025
Last Update Date : 12/24/2025

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Directions to “ BENJAMIN CRAWFORD RN” Practice Location

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