Provider Demographics
NPI:1326254178
Name:CRUMB, ELAINE M (RN)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:CRUMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-1229
Mailing Address - Country:US
Mailing Address - Phone:440-242-4015
Mailing Address - Fax:
Practice Address - Street 1:943 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-1229
Practice Address - Country:US
Practice Address - Phone:440-242-4015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122853163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice