Provider Demographics
NPI:1609922533
Name:CRUMP, EVELYN (NP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:CRUMP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 JEFFERSON AVE
Mailing Address - Street 2:WALK IN MEDICAL CARE
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1800
Mailing Address - Country:US
Mailing Address - Phone:302-672-2319
Mailing Address - Fax:302-672-2341
Practice Address - Street 1:119 NEUROLOGY WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-0000
Practice Address - Country:US
Practice Address - Phone:302-424-3900
Practice Address - Fax:302-424-4189
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000398363LF0000X
DELH-0000127363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1609922533Medicaid