Individual
SHELLY LYNN CROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
448 N STATE ROUTE 89 STE H, CHINO VALLEY, AZ 86323-5957
(928) 499-2915
(877) 406-3180
Mailing address
1042 WILLOW CREEK RD SUITE A101, PO BOX 416, PRESCOTT, AZ 86301-1673
(928) 499-2915
(877) 406-3180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP11069
AZ
363LF0000X
Family Nurse Practitioner
AP11069
AZ
363LF0000X
Family Nurse Practitioner
F337984-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
395116
—
AZ
Enumeration date
07/30/2013
Last updated
02/13/2024
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