Provider Demographics
NPI:1285202291
Name:CRAWFORD, EVELYNY
Entity type:Individual
Prefix:
First Name:EVELYNY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:KPARYEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 N 5TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3906
Mailing Address - Country:US
Mailing Address - Phone:323-304-3185
Mailing Address - Fax:
Practice Address - Street 1:800 N 5TH ST APT 2
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3906
Practice Address - Country:US
Practice Address - Phone:070-198-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant