Provider Demographics
NPI:1780898007
Name:CRUMP, FELICIA LOUISE (WHNP)
Entity type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:LOUISE
Last Name:CRUMP
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7219 N LITCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LUKE AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85309-1529
Mailing Address - Country:US
Mailing Address - Phone:623-856-4003
Mailing Address - Fax:
Practice Address - Street 1:7219 N LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:LUKE AFB
Practice Address - State:AZ
Practice Address - Zip Code:85309-1529
Practice Address - Country:US
Practice Address - Phone:623-856-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN66164363LX0001X
MDR117585363LX0001X
AZRN152990363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology