Provider Demographics
NPI:1780190314
Name:CRAWSHAW, FAY HANNAH (PA-C)
Entity type:Individual
Prefix:
First Name:FAY
Middle Name:HANNAH
Last Name:CRAWSHAW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 NUCKOLS RD STE C
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5565
Mailing Address - Country:US
Mailing Address - Phone:804-888-6800
Mailing Address - Fax:804-888-6800
Practice Address - Street 1:11551 NUCKOLS RD STE C
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5565
Practice Address - Country:US
Practice Address - Phone:804-888-6800
Practice Address - Fax:804-888-6800
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13643363A00000X
VA0110006028363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA13643OtherTEXAS MEDICAL BOARD