Individual
MRS. BARBARA DEW CRISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 N COURT ST, SUMNER, MS 38957-9710
(662) 375-9989
(662) 375-8762
Mailing address
PO BOX 27, CHARLESTON, MS 38921-0027
(662) 647-5816
(662) 647-5705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R532355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114642
—
MS
01
—
500001378
MEDICARE PART B
MS
Enumeration date
08/18/2006
Last updated
05/09/2011
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