Individual
ELIZABETH LEE CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4092 FOXWOOD DR, STE 101, VIRGINIA BEACH, VA 23462-5225
(757) 686-3508
(757) 686-0541
Mailing address
PO BOX 7549, PORTSMOUTH, VA 23707-0549
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110003870
VA
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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