Provider Demographics
NPI:1376791756
Name:CRAWFORD MCCOOL, SANDI JOY (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDI
Middle Name:JOY
Last Name:CRAWFORD MCCOOL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:JOY
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:216 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3113
Mailing Address - Country:US
Mailing Address - Phone:610-566-2830
Mailing Address - Fax:
Practice Address - Street 1:216 W STATE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3113
Practice Address - Country:US
Practice Address - Phone:610-566-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP003423G364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA044344Medicare PIN