Individual
ELIZABETH CRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 752-6781
Mailing address
PO BOX Q, GRAND RAPIDS, MI 49501-4917
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704241417
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4991343
—
MI
01
—
EC241417
BCBS
MI
01
—
P00469928
RAILROAD MEDICARE
—
Enumeration date
04/26/2007
Last updated
05/21/2008
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