Provider Demographics
NPI:1174015184
Name:CRENSHAW, CHRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CRENSHAW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 FOLSOM DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7274
Mailing Address - Country:US
Mailing Address - Phone:409-832-6545
Mailing Address - Fax:409-832-7494
Practice Address - Street 1:6510 FOLSOM DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7274
Practice Address - Country:US
Practice Address - Phone:409-832-6545
Practice Address - Fax:409-832-7494
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily