Provider Demographics
NPI:1154572444
Name:CRUMPLER, OMESHIA LASHONDA
Entity type:Individual
Prefix:MS
First Name:OMESHIA
Middle Name:LASHONDA
Last Name:CRUMPLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 RAMSEY ST STE E
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-3416
Mailing Address - Country:US
Mailing Address - Phone:910-884-3064
Mailing Address - Fax:910-884-3068
Practice Address - Street 1:5851 RAMSEY ST STE E
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-3416
Practice Address - Country:US
Practice Address - Phone:910-884-3064
Practice Address - Fax:910-884-3068
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider