Individual
VIRGINIA CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
105 COMMERCE ST, POWELLSVILLE, NC 27967
(252) 332-6484
Mailing address
PO BOX 40, POWELLSVILLE, NC 27967-0040
(252) 332-6484
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
600104
NC
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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