Individual
STACIE L CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 735-0501
(651) 251-8050
Mailing address
1602 FREMONT AVE N, MINNEAPOLIS, MN 55411-3235
(612) 522-3203
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1127791
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500602300
—
MN
01
—
61G39CR
BCBS
MN
Enumeration date
09/21/2006
Last updated
07/08/2007
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