Individual
DR. NATHANIEL C CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
405 W MAIN ST, CARBONDALE, IL 62901-2903
(618) 549-0721
(618) 529-0449
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 549-0721
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11041964
FL
367500000X
Certified Registered Nurse Anesthetist
209.016465
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MEDICARE GROUP PTAN
IL
Enumeration date
08/31/2017
Last updated
10/16/2025
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