Provider Demographics
NPI:1144263898
Name:CRAWFORD, AMANDA COUCH (CRNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:COUCH
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PRINCETON AVENUE SW
Mailing Address - Street 2:SUITE 4102
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1303
Mailing Address - Country:US
Mailing Address - Phone:205-264-2050
Mailing Address - Fax:205-264-2049
Practice Address - Street 1:701 PRINCETON AVE SW STE 4102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1303
Practice Address - Country:US
Practice Address - Phone:205-264-2050
Practice Address - Fax:205-264-2049
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-084880363LA2100X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051527745OtherBLUE CROSS
AL460001063OtherRAILROAD MEDICARE
AL891009210Medicaid
AL000036160OtherBLUE CROSS
AL891009200Medicaid
AL051518137OtherBLUE CROSS
AL891009220Medicaid
AL051518139OtherBLUE CROSS
AL051518137OtherBLUE CROSS
AL051527745OtherBLUE CROSS