Individual
BRANDON CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
844 KEMPSVILLE RD STE 212, NORFOLK, VA 23502-3927
(757) 261-5977
Mailing address
844 KEMPSVILLE RD STE 212, NORFOLK, VA 23502-3927
(757) 261-5977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024188321
VA
363L00000X
Nurse Practitioner
34380
TN
Other
Enumeration date
08/03/2023
Last updated
12/13/2023
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