Provider Demographics
NPI:1609192350
Name:CRASS, JOANNE GINGRICH (RN)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:GINGRICH
Last Name:CRASS
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 1:1100 LASKIN RD
Mailing Address - Street 2:STE 105
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5274
Mailing Address - Country:US
Mailing Address - Phone:757-377-5352
Mailing Address - Fax:
Practice Address - Street 1:917 BOBOLINK DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-4944
Practice Address - Country:US
Practice Address - Phone:757-228-3761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001 182790163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health