Provider Demographics
NPI:1083458665
Name:CRAWFORD, ASHLIN
Entity type:Individual
Prefix:
First Name:ASHLIN
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLIN
Other - Middle Name:
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4121 KINGS RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:BAUXITE
Mailing Address - State:AR
Mailing Address - Zip Code:72011-5017
Mailing Address - Country:US
Mailing Address - Phone:870-740-5708
Mailing Address - Fax:
Practice Address - Street 1:4121 KINGS RIVER TRL
Practice Address - Street 2:
Practice Address - City:BAUXITE
Practice Address - State:AR
Practice Address - Zip Code:72011-5017
Practice Address - Country:US
Practice Address - Phone:870-740-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR228990163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse