Individual
ELIZABETH ANN CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003663
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982921
—
MI
01
—
970024650
RAILROAD MEDICARE
MI
Enumeration date
11/07/2005
Last updated
06/06/2013
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