Basic Information
Provider Information | |||||||||
NPI: | 1427423656 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | CRAWFORD | ||||||||
FirstName: | OLIVIA | ||||||||
MiddleName: | ANN | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 260 WALKER RD | ||||||||
Address2: |   | ||||||||
City: | BURGETTSTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 150212505 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7247474094 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 6225 N STATE HIGHWAY 161 | ||||||||
Address2: | STE# 200 | ||||||||
City: | IRVING | ||||||||
State: | TX | ||||||||
PostalCode: | 75038 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2146870001 | ||||||||
FaxNumber: | 9725182100 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/14/2015 | ||||||||
LastUpdateDate: | 06/18/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN644366 | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |   |
No ID Information.