MEDICARE: DEBORAH FISH CRAWFORD NP

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	363LA2200X	Adult Health Nurse Practitioner	186087	NC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	600136	NC

General Provider Information

NPI Number	:	1538185202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH FISH CRAWFORD NP

Provider Business Mailing Address
First Line	:	2012 TALBOT LN
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9165
Country	:	US
Telephone Number	:	828-455-9031
Fax Number	:	828-294-0367

Provider Business Practice Location Address
First Line	:	2012 TALBOT LN
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9165
Country	:	US
Telephone Number	:	828-455-9031
Fax Number	:	828-294-0367

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/02/2012

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