Individual
MRS. FANIKA SHUNTAE CRUMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
101 HOLMAN ST, CRYSTAL SPRINGS, MS 39059-2582
(601) 201-1130
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R882847
MS
163WM0705X
Medical-Surgical Registered Nurse
R882847
MS
Other
Enumeration date
12/14/2011
Last updated
07/03/2025
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