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Individual

MARY G. CRUTCHFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP, FNP

Contact information

Practice address
4445 CORPORATION LN STE 110, VIRGINIA BEACH, VA 23462-3264
(757) 453-5508
(757) 216-9655
Mailing address
4445 CORPORATION LN STE 110, VIRGINIA BEACH, VA 23462-3264
(757) 453-5508
(757) 216-9655

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024169848
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-022
CHAMPUS/TRICARE
VA
01
10090356N
OPTIMA HEALTH
VA
01
1366715112
VIRGINIA PREMIER HEALTH PLAN
VA
05
1366715112
VA
05
7005918
NC
01
PAR
MULTIPLAN
VA
Enumeration date
02/09/2012
Last updated
11/30/2025
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