Provider Demographics
NPI:1629467261
Name:CRAWFORD, KRISTIN MICHELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MICHELLE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MICHELLE
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6421 BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2468
Mailing Address - Country:US
Mailing Address - Phone:214-208-8150
Mailing Address - Fax:
Practice Address - Street 1:6201 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5202
Practice Address - Country:US
Practice Address - Phone:214-633-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX778929163W00000X
TX104692367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse