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Individual

MISS JACQUELINE LOVE CRUMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
89 W COPELAND DR, ORLANDO, FL 32806-2002
(321) 841-7550
(321) 841-8185
Mailing address
89 W COPELAND DR, ORLANDO, FL 32806-2002
(321) 841-7550
(321) 841-8185

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9192919
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9192919
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
308735200
FL
01
ARNP9192919
MEDICAL LICENSE
FL
Enumeration date
03/09/2007
Last updated
11/16/2016
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