# JILL S CRABTREE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912918657
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 10003191A | IN | — |
| 363A00000X | Physician Assistant | PA570 | KY | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 05/27/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0221879 | — | OH |
| 05 | — | 300048421 | — | IN |
| 05 | — | 95000501 | — | KY |
| 01 | — | P00813820 | RAILROAD MEDICARE | KY |