Provider Demographics
NPI:1902853278
Name:CRIM, ANN S (APN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:S
Last Name:CRIM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:L
Other - Last Name:SUTTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1614 WELLINGTON GRN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5359
Mailing Address - Country:US
Mailing Address - Phone:615-794-1814
Mailing Address - Fax:
Practice Address - Street 1:1614 WELLINGTON GRN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5359
Practice Address - Country:US
Practice Address - Phone:615-794-1814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11850363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36426231OtherPTAN
TN36426231OtherPTAN
TNQ66623Medicare UPIN