Provider Demographics
NPI:1134849896
Name:CRESPO-RAMOS, NEISHA ANGELICA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:NEISHA
Middle Name:ANGELICA
Last Name:CRESPO-RAMOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 HIGHWAY 411
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-1560
Mailing Address - Country:US
Mailing Address - Phone:423-427-2402
Mailing Address - Fax:423-427-2403
Practice Address - Street 1:4008 HIGHWAY 411
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-1560
Practice Address - Country:US
Practice Address - Phone:423-427-2402
Practice Address - Fax:423-427-2403
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TN6250363A00000X
FLPA9116362363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant