Provider Demographics
NPI:1790215424
Name:CRUMPTON, LAURA REBECCA (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:REBECCA
Last Name:CRUMPTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 GRAYSON RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9170
Mailing Address - Country:US
Mailing Address - Phone:803-230-9485
Mailing Address - Fax:
Practice Address - Street 1:1070 HECKLE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2855
Practice Address - Country:US
Practice Address - Phone:803-909-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN105190163WC1500X, 163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health