Provider Demographics
NPI:1811747397
Name:CRAWFORD, JAMES ROBERT (FNP-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 N 3600 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7113
Mailing Address - Country:US
Mailing Address - Phone:801-635-7719
Mailing Address - Fax:
Practice Address - Street 1:152 N 3600 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7113
Practice Address - Country:US
Practice Address - Phone:801-635-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7861398-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily