Individual
ROBERT DAVID CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(615) 355-3451
Mailing address
2828 N NATIONAL AVE, SPRINGFIELD, MO 65803-4306
(417) 837-4000
(417) 875-4714
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
2000160927
MO
363LF0000X
Family Nurse Practitioner
Primary
2000160927
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427473004
—
MO
01
—
P00269324
RR MEDICARE
—
Enumeration date
09/29/2005
Last updated
09/03/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us