Provider Demographics
NPI:1437333572
Name:CRABB, JULIE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:CRABB
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 1:30090 BURNUP RD
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:13612-2207
Mailing Address - Country:US
Mailing Address - Phone:315-773-4718
Mailing Address - Fax:
Practice Address - Street 1:258 CHAMPION ST
Practice Address - Street 2:APT 503
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-3361
Practice Address - Country:US
Practice Address - Phone:315-493-7841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY472645-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health