Provider Demographics
NPI:1689007643
Name:CRAWFORD, ABIGAIL A (CRNP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:A
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HEALTH CARE LN
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-4009
Mailing Address - Country:US
Mailing Address - Phone:304-264-9121
Mailing Address - Fax:304-264-9128
Practice Address - Street 1:128 HEALTH CARE LN
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-4009
Practice Address - Country:US
Practice Address - Phone:304-264-9121
Practice Address - Fax:304-264-9128
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207242363LF0000X
WVAPRN84842NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211809OtherMEDICARE FQHC