Provider Demographics
NPI:1861874182
Name:CRAWFORD, ALI (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ALI
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 REIDS AVE
Mailing Address - Street 2:
Mailing Address - City:POTTS CAMP
Mailing Address - State:MS
Mailing Address - Zip Code:38659-8298
Mailing Address - Country:US
Mailing Address - Phone:662-333-4333
Mailing Address - Fax:
Practice Address - Street 1:3 REIDS AVE
Practice Address - Street 2:
Practice Address - City:POTTS CAMP
Practice Address - State:MS
Practice Address - Zip Code:38659-8298
Practice Address - Country:US
Practice Address - Phone:662-333-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR882698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily