Provider Demographics
NPI:1134711971
Name:CREWS, AMANDA ASHLEY (NP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ASHLEY
Last Name:CREWS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 STRAWBERRY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CALLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24530-2402
Mailing Address - Country:US
Mailing Address - Phone:434-770-4830
Mailing Address - Fax:
Practice Address - Street 1:7768 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:HOLLINS
Practice Address - State:VA
Practice Address - Zip Code:24019-4343
Practice Address - Country:US
Practice Address - Phone:540-769-3964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180793363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner