Provider Demographics
NPI:1932350667
Name:CRIM, JAMES M (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:CRIM
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-0507
Mailing Address - Country:US
Mailing Address - Phone:913-381-5200
Mailing Address - Fax:913-381-0979
Practice Address - Street 1:7152 COCA SABAL LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4263
Practice Address - Country:US
Practice Address - Phone:305-468-4185
Practice Address - Fax:305-675-3378
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC02722367500000X
FLAPRN11013726367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175005001Medicaid
AR175005001Medicaid
ARP00665560Medicare PIN