Basic Information
| Provider Information | |||||||||
| NPI: | 1487184834 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRAWFORD | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SILVERS | ||||||||
| OtherFirstName: | STEPHANIE | ||||||||
| OtherMiddleName: | CAROL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1605 WESTGATE CIRCLE | ||||||||
| Address2: | BOX 100 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156780024 | ||||||||
| FaxNumber: | 6156106331 | ||||||||
| Practice Location | |||||||||
| Address1: | 1605 WESTGATE CIR STE 100 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370278396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156780024 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2017 | ||||||||
| LastUpdateDate: | 06/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 11288 | TN | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.