1184009276 NPI number — MISS ERICA ASHLEY CRAWFORD MSN, FNP-C

Table of content: MISS ERICA ASHLEY CRAWFORD MSN, FNP-C (NPI 1184009276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184009276 NPI number — MISS ERICA ASHLEY CRAWFORD MSN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAWFORD
Provider First Name:
ERICA
Provider Middle Name:
ASHLEY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MSN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184009276
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3017 CAROLINE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63104-1804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-783-6140
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4251 FOREST PARK AVE
Provider Second Line Business Practice Location Address:
PLANNED PARENTHOOD
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-531-7526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  2015011091 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)