Individual
DEANE NICOLE CRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1001 US HIGHWAY 83 N, CHILDRESS, TX 79201-2322
(940) 937-3636
(940) 937-9554
Mailing address
1001 US HIGHWAY 83 N, CHILDRESS, TX 79201-2322
(940) 937-3636
(940) 937-9554
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285481201
—
TX
05
—
285481202
—
TX
01
—
P01010811
RAILROAD
TX
Enumeration date
07/06/2011
Last updated
09/12/2016
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