Provider Demographics
NPI:1568084242
Name:CRUMPTON, LISA EDWARDS (FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:EDWARDS
Last Name:CRUMPTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 COUNTY ROAD 911
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36767-2710
Mailing Address - Country:US
Mailing Address - Phone:334-996-8128
Mailing Address - Fax:
Practice Address - Street 1:5915 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2507
Practice Address - Country:US
Practice Address - Phone:334-245-8736
Practice Address - Fax:334-245-1771
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-049552163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse