Individual
LERRYN U CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADN BSN MSN FNP
Contact information
Practice address
25 HOSPITAL CENTER BLVD, HILTON HEAD ISLAND, SC 29926-2738
(843) 784-8224
Mailing address
4331 THURMOND TANNER RD, FLOWERY BRANCH, GA 30542
(678) 513-5733
(678) 513-5836
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN059534 CNS/PMH NP
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
22182
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN059534 CNS/PMH NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000970109A
—
GA
05
—
00970109A
—
GA
Enumeration date
10/25/2005
Last updated
05/20/2019
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