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Individual

MRS. HOLLIE G CRUTCHFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1118 ROSS CLARK CIR, SUITE 403, DOTHAN, AL 36301-3001
(334) 793-5672
(334) 794-0378
Mailing address
1118 ROSS CLARK CIR, SUITE 403, DOTHAN, AL 36301-3001
(334) 793-5672
(334) 794-0378

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1088734
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051520456
BCBS OF AL #
AL
05
051551009
AL
Enumeration date
05/22/2006
Last updated
02/14/2012
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