Provider Demographics
NPI:1093328684
Name:CRAWFORD, ALYSSA (APRN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:PANHANDLE
Mailing Address - State:TX
Mailing Address - Zip Code:79068-0010
Mailing Address - Country:US
Mailing Address - Phone:806-532-2273
Mailing Address - Fax:806-532-2276
Practice Address - Street 1:102 US HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:PANHANDLE
Practice Address - State:TX
Practice Address - Zip Code:79068-7200
Practice Address - Country:US
Practice Address - Phone:806-532-2273
Practice Address - Fax:806-532-2276
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009396363LF0000X, 363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care