Provider Demographics
NPI:1346940350
Name:CRAWFORD, KIARA
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 NORTON ST
Mailing Address - Street 2:
Mailing Address - City:GREEN SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:26722-4674
Mailing Address - Country:US
Mailing Address - Phone:304-359-7411
Mailing Address - Fax:
Practice Address - Street 1:70 NORTON ST
Practice Address - Street 2:
Practice Address - City:GREEN SPRING
Practice Address - State:WV
Practice Address - Zip Code:26722-4674
Practice Address - Country:US
Practice Address - Phone:304-359-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant