Provider Demographics
NPI:1972280048
Name:CRAWFORD, IAN CLOID (NP-BC)
Entity Type:Individual
Prefix:MR
First Name:IAN
Middle Name:CLOID
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 TURNMILL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5566
Mailing Address - Country:US
Mailing Address - Phone:804-401-0807
Mailing Address - Fax:
Practice Address - Street 1:7607 FOREST AVE STE 220
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4913
Practice Address - Country:US
Practice Address - Phone:804-285-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner