Provider Demographics
NPI:1760554216
Name:CRAWFORD, SHELLYE ELAINE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:SHELLYE
Middle Name:ELAINE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-8190
Mailing Address - Fax:214-456-5071
Practice Address - Street 1:1935 MEDICAL DISTRICT DR.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-8190
Practice Address - Fax:214-456-5071
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594184363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXUT000CH54OtherBLUE SHIELD
TN7000156OtherAETNA
TX16801001OtherPARKLAND HEALTH FIRST
TX168010001Medicaid
TX0TH000Medicare UPIN