Provider Demographics
NPI:1841999265
Name:CROSTON, DAVID SCOTT (APRN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:CROSTON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 J D ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3494
Mailing Address - Country:US
Mailing Address - Phone:304-598-1200
Mailing Address - Fax:304-598-1699
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-242-8900
Practice Address - Fax:717-248-0502
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV115734363LC0200X
PASP028127363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV115734OtherWEST VIRGINIA BOARD OF NURSING