Provider Demographics
NPI:1255159430
Name:CRABTREE, AMY ELIZABETH (AGNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1310 MARY ALICE PARK RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-5348
Mailing Address - Country:US
Mailing Address - Phone:865-696-8906
Mailing Address - Fax:
Practice Address - Street 1:428 CANTON RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2002
Practice Address - Country:US
Practice Address - Phone:770-781-6900
Practice Address - Fax:770-781-6929
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN196964363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner