Provider Demographics
NPI:1538030697
Name:CRAWFORD, RAQUEL MICHELLE
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:MICHELLE
Last Name:CRAWFORD
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 1:4424 PANUI ST
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-9576
Mailing Address - Country:US
Mailing Address - Phone:210-334-1665
Mailing Address - Fax:
Practice Address - Street 1:4424 PANUI ST
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-9576
Practice Address - Country:US
Practice Address - Phone:210-334-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-113303163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology