Individual
STACY CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
795 PATRIOT PKWY, 208, ROCK HILL, SC 29730-2336
(404) 430-9251
Mailing address
795 PATRIOT PKWY, 208, ROCK HILL, SC 29730-2336
(404) 430-9251
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P45203
SC
172V00000X
Community Health Worker
—
—
343800000X
Secured Medical Transport (VAN)
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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