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Individual
JILL S CRABTREE
Active
Individual
JILL S CRABTREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003191A
IN
363A00000X
Physician Assistant
Primary
PA570
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0221879
—
OH
05
—
300048421
—
IN
05
—
95000501
—
KY
01
—
P00813820
RAILROAD MEDICARE
KY
Enumeration date
08/10/2006
Last updated
05/27/2021
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