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Individual

CORRIE CRUMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNPC-AG

Contact information

Practice address
2900 STATE ST, MEDFORD, OR 97504-8458
(541) 779-1672
Mailing address
3457 DURST ST, MEDFORD, OR 97504-4221
(330) 501-0444

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
202112389NP-PP
OR

Other

Enumeration date
10/04/2024
Last updated
10/04/2024
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