Organization
CAROL L. CROCKER, FNP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL L. CROCKER MD (PRESIDENT)
(541) 726-4400
Entity
Organization
Contact information
Practice address
1460 G ST, SPRINGFIELD, OR 97477-4112
(541) 726-4400
Mailing address
PO BOX 11840, WESTMINSTER, CA 92685-1840
(562) 468-0227
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200450098NP
OR
Other
Enumeration date
10/07/2008
Last updated
02/11/2009
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