Individual
CHUCKEIA V CRUMBLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA, HHA
Contact information
Practice address
1400 13TH ST S, SAINT PETERSBURG, FL 33705-2410
(727) 509-5523
Mailing address
PO BOX 35348, SAINT PETERSBURG, FL 33705-0506
(727) 509-5523
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
Primary
329492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C651118859280
DRIVER LIC
FL
Enumeration date
07/03/2021
Last updated
07/03/2021
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