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Individual

MS. BRENDA RAE CRUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
2280 OPITZ BLVD STE 110, WOODBRIDGE, VA 22191-3362
(703) 523-8880
(757) 648-1954
Mailing address
2280 OPITZ BLVD STE 110, WOODBRIDGE, VA 22191-3362
(703) 523-8880
(757) 648-1954

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
24131318
VA
363LF0000X
Family Nurse Practitioner
Primary
0024131318
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7792085
VA
Enumeration date
05/31/2006
Last updated
07/21/2021
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