Individual
KELLY CRENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6112 SAINT GILES ST, RALEIGH, NC 27612-7043
(919) 893-4465
Mailing address
6112 SAINT GILES ST STE 103, RALEIGH, NC 27612-7043
(919) 893-4465
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
5007819
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5007819
NC
Other
Enumeration date
08/06/2015
Last updated
12/04/2024
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