Provider Demographics
NPI:1306099072
Name:CRUTCHFIELD, CINDY F
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:F
Last Name:CRUTCHFIELD
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 1:186 TODD LN
Mailing Address - Street 2:
Mailing Address - City:MC MINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-5087
Mailing Address - Country:US
Mailing Address - Phone:931-668-7831
Mailing Address - Fax:
Practice Address - Street 1:3499 MAIN ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367
Practice Address - Country:US
Practice Address - Phone:423-447-8579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist