Provider Demographics
NPI:1518190586
Name:CRUMBLEY, DORCAS A (BA, CNA, HHA)
Entity Type:Individual
Prefix:MRS
First Name:DORCAS
Middle Name:A
Last Name:CRUMBLEY
Suffix:
Gender:F
Credentials:BA, CNA, HHA
Other - Prefix:MRS
Other - First Name:DEE
Other - Middle Name:AL
Other - Last Name:CRUMBLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA, CNA, HHA
Mailing Address - Street 1:958 WHISPER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1771
Mailing Address - Country:US
Mailing Address - Phone:863-393-6368
Mailing Address - Fax:863-688-8004
Practice Address - Street 1:958 WHISPER LAKE DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-1771
Practice Address - Country:US
Practice Address - Phone:863-393-6368
Practice Address - Fax:863-688-8004
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA170964374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide