Individual
LACEY L CRABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1414 W FAIR AVE, SUITE 342, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-3975
Mailing address
1414 W FAIR AVE, SUITE 342, MARQUETTE, MI 49855-2675
(906) 225-3870
(906) 225-3975
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4704244170
MI
363L00000X
Nurse Practitioner
Primary
4704244170
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0870768
BCBS OF MI
MI
05
—
1437306321
—
MI
01
—
5008707680
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/21/2008
Last updated
06/09/2009
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