Provider Demographics
NPI:1821726357
Name:CRAWFORD, PAMELA ANN (STNA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 GRAND DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1242
Mailing Address - Country:US
Mailing Address - Phone:216-288-4949
Mailing Address - Fax:
Practice Address - Street 1:7905 GRAND DIVISION AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-1242
Practice Address - Country:US
Practice Address - Phone:216-288-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH365251770691374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide