Individual
MRS. DIANA P CROWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1755 N MECKLENBURG AVE, SOUTH HILL, VA 23970-4080
(434) 447-3151
(434) 584-5023
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001616
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010117852
—
VA
Enumeration date
08/09/2005
Last updated
07/01/2024
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