Provider Demographics
NPI:1528732468
Name:CRAWFORD, DENNIS SCOTT (CNP)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:SCOTT
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:NM
Mailing Address - Zip Code:87552
Mailing Address - Country:US
Mailing Address - Phone:505-757-6482
Mailing Address - Fax:505-443-8304
Practice Address - Street 1:199 HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:NM
Practice Address - Zip Code:87552
Practice Address - Country:US
Practice Address - Phone:505-757-6482
Practice Address - Fax:505-443-8304
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM64594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily