Individual
DANIELLE CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 KRESGE WAY STE 210, LOUISVILLE, KY 40207-4640
(502) 895-1995
Mailing address
2526 MEADOW DR, LOUISVILLE, KY 40218-1361
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PENDING
KY
Other
Enumeration date
07/23/2021
Last updated
08/18/2021
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