Provider Demographics
NPI:1952628976
Name:CRUMPLER, DONNA GAYLE (SA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:GAYLE
Last Name:CRUMPLER
Suffix:
Gender:F
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-0044
Mailing Address - Country:US
Mailing Address - Phone:214-478-5501
Mailing Address - Fax:
Practice Address - Street 1:926 AUSTIN CT
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6345
Practice Address - Country:US
Practice Address - Phone:214-478-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist