Provider Demographics
NPI:1629554043
Name:CRUMPTON, ELIZABETH K (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:CRUMPTON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 496
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-0009
Mailing Address - Country:US
Mailing Address - Phone:706-219-2273
Mailing Address - Fax:706-865-4646
Practice Address - Street 1:84 HELEN HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-7804
Practice Address - Country:US
Practice Address - Phone:706-219-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN112053163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy