Provider Demographics
NPI:1114328697
Name:CRAWFORD, ADRIENNE (CNM, RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CNM, RN, IBCLC
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 5985
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-5985
Mailing Address - Country:US
Mailing Address - Phone:404-723-3496
Mailing Address - Fax:
Practice Address - Street 1:113 BARREN SPOT MALL
Practice Address - Street 2:SUITE 9
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00850
Practice Address - Country:US
Practice Address - Phone:404-723-3496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA824971163WL0100X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant