Provider Demographics
NPI:1598154148
Name:CRAWFORD, CAROLYN (RN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:CRAWFORD
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 1:555 1/2 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1334
Mailing Address - Country:US
Mailing Address - Phone:814-464-4839
Mailing Address - Fax:
Practice Address - Street 1:555 1/2 W 7TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1334
Practice Address - Country:US
Practice Address - Phone:814-464-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN302424L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse