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NPI Code Detail

MEDICARE: JENNIFER CRUMM PA

MEDICARE:   JENNIFER  CRUMM  PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1679902134
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CRUMM PA
Provider Business Mailing Address
First Line : 7801 OAKMONT BLVD
Second Line : STE 101
City : FT WORTH
State : TX
Zip : 76132-4204
Country : US
Telephone Number : 817-263-0007
Fax Number : 817-263-1118
Provider Business Practice Location Address
First Line : 7801 OAKMONT BLVD
Second Line : STE 101
City : FT WORTH
State : TX
Zip : 76132-4204
Country : US
Telephone Number : 817-263-0007
Fax Number : 817-263-1118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2013
Last Update Date : 11/05/2013

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Directions to “ JENNIFER CRUMM PA” Practice Location

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