Provider Demographics
NPI:1588695175
Name:CRABTREE, JUDY R (RN CS MN FNPC)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:R
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:RN CS MN FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 PRYTANIA STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-895-9044
Mailing Address - Fax:504-895-5405
Practice Address - Street 1:3600 PRYTANIA STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-895-9044
Practice Address - Fax:504-895-5405
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN035231163W00000X
LAAP03366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P10097Medicare UPIN
4B488Medicare ID - Type Unspecified