Provider Demographics
NPI:1790840791
Name:CROSS, ABBIE KAYE (PA)
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:KAYE
Last Name:CROSS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1540 S D RD
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-3805
Mailing Address - Country:US
Mailing Address - Phone:308-641-2861
Mailing Address - Fax:
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:SUITE 120
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4669
Practice Address - Country:US
Practice Address - Phone:308-635-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant