Provider Demographics
NPI:1740028448
Name:CRAWFORD, KRISTIN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 FITZPATRICK WAY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1002
Mailing Address - Country:US
Mailing Address - Phone:770-354-9247
Mailing Address - Fax:
Practice Address - Street 1:41 PERIMETER CTR E
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30346-1910
Practice Address - Country:US
Practice Address - Phone:770-871-3727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN176802363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health