Provider Demographics
NPI:1306257084
Name:CRABTREE, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CRABTREE
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 1:612-4 JEFFERSON STREET
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3708
Mailing Address - Country:US
Mailing Address - Phone:910-642-3065
Mailing Address - Fax:910-642-3765
Practice Address - Street 1:612-4 JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3708
Practice Address - Country:US
Practice Address - Phone:910-642-3065
Practice Address - Fax:910-642-3765
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110521835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy