Provider Demographics
NPI:1639525975
Name:CRABTREE, EMILY BROOKE (FNP-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BROOKE
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29761 U S HIGHWAY 58
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-5304
Mailing Address - Country:US
Mailing Address - Phone:276-393-2742
Mailing Address - Fax:
Practice Address - Street 1:1014 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1823
Practice Address - Country:US
Practice Address - Phone:276-679-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001225320163W00000X
VA0024173523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVL570B288Medicare PIN