Provider Demographics
NPI:1629826003
Name:CRAWFORD, CHELANA LARUE (CRNP)
Entity type:Individual
Prefix:
First Name:CHELANA
Middle Name:LARUE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 ALTER RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2809
Mailing Address - Country:US
Mailing Address - Phone:172-485-9780
Mailing Address - Fax:
Practice Address - Street 1:116 BROWNS HILL RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:PA
Practice Address - Zip Code:16059-3144
Practice Address - Country:US
Practice Address - Phone:724-933-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029729363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner