Provider Demographics
NPI:1144229998
Name:CRUMP, LINDA M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:CRUMP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 HIGH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-6300
Mailing Address - Country:US
Mailing Address - Phone:270-885-0570
Mailing Address - Fax:270-885-0573
Practice Address - Street 1:1717 HIGH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-6300
Practice Address - Country:US
Practice Address - Phone:270-885-0570
Practice Address - Fax:270-885-0573
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003131363L00000X
KY1073349363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78006533Medicaid
KY65941031Medicaid
KY000000315837OtherANTHEM
KY0796103Medicare PIN
KYP00109815Medicare ID - Type UnspecifiedMEDICARE RAILROAD
KY78006533Medicaid
KY0796203Medicare PIN
KYP41860Medicare ID - Type Unspecified