Provider Demographics
NPI:1619511052
Name:CRAWFORD LEE, EVAN SUNSHINE (RN)
Entity type:Individual
Prefix:MRS
First Name:EVAN
Middle Name:SUNSHINE
Last Name:CRAWFORD LEE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:EVAN
Other - Middle Name:SUNSHINE
Other - Last Name:CRAWFORD LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2918 E WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-8724
Mailing Address - Country:US
Mailing Address - Phone:706-529-4600
Mailing Address - Fax:
Practice Address - Street 1:2918 E WALNUT AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8724
Practice Address - Country:US
Practice Address - Phone:706-529-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN268115363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner