Provider Demographics
NPI:1902039423
Name:EDIC-CRAWFORD, DARLENE M (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:M
Last Name:EDIC-CRAWFORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 PGA BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2823
Mailing Address - Country:US
Mailing Address - Phone:561-219-4470
Mailing Address - Fax:
Practice Address - Street 1:3401 PGA BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2823
Practice Address - Country:US
Practice Address - Phone:561-219-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2151172363L00000X
FLARNP2151172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2151172OtherSTATE LICENSE