Provider Demographics
NPI:1902449465
Name:CRAWFORD, HANNA GAYLE (NP)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:GAYLE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 ALCOA HWY STE 330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1547
Mailing Address - Country:US
Mailing Address - Phone:865-305-9218
Mailing Address - Fax:865-305-8262
Practice Address - Street 1:1926 ALCOA HWY STE 330
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1547
Practice Address - Country:US
Practice Address - Phone:865-305-9218
Practice Address - Fax:865-305-8262
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ048105Medicaid