Provider Demographics
NPI:1467468397
Name:CRAWFORD, RHONDA L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:L
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:L
Other - Last Name:NUNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-0417
Mailing Address - Fax:606-408-6069
Practice Address - Street 1:384 COUNTY ROAD 120 S
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7807
Practice Address - Country:US
Practice Address - Phone:740-894-2080
Practice Address - Fax:740-894-5406
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003559363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78006699Medicaid
KY0586635Medicare PIN
KY78006699Medicaid
KY500022112Medicare PIN
KY0307619Medicare ID - Type Unspecified
KY95001418Medicaid
S06887Medicare UPIN
KY0351417Medicare ID - Type Unspecified
KY78006699Medicaid
KY0586635Medicare PIN