Individual
CHRISTIE RAE CRUMP
Active
Individual
CHRISTIE RAE CRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN155758
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01377753
AMERIGROUP
GA
05
—
222017877A
—
GA
05
—
222017877B
—
GA
05
—
222017877C
—
GA
05
—
222017877D
—
GA
05
—
222017877E
—
GA
01
—
567122
WELLCARE
GA
Enumeration date
09/09/2010
Last updated
09/05/2012
Update your record
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