Provider Demographics
NPI:1245710912
Name:CRAWLEY, DANA L
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 HARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-7530
Mailing Address - Country:US
Mailing Address - Phone:804-939-8114
Mailing Address - Fax:
Practice Address - Street 1:1416 HARWOOD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-7530
Practice Address - Country:US
Practice Address - Phone:804-939-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1030277343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)