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NPI Code Detail

MEDICARE: MELISSA DAWN CRAWFORD

MEDICARE: MELISSA DAWN CRAWFORD
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
1363LF0000XFamily Nurse Practitioner2022008982MO

General Provider Information

NPI Number : 1801462551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA DAWN CRAWFORD
Provider Business Mailing Address
First Line : PO BOX 1359
Second Line :
City : AVA
State : MO
Zip : 65608-1359
Country : US
Telephone Number : 417-683-5739
Fax Number :
Provider Business Practice Location Address
First Line : 1340 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2045
Country : US
Telephone Number : 417-967-0772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 04/28/2022

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Directions to “ MELISSA DAWN CRAWFORD ” Practice Location

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