Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0360 | SC |
NPI | 1023017506 |
---|---|
Provider Name | Dr. Cindy Crittendon |
First Address | Bennettsville, SC 29512-2495 |
Second Address | Bennettsville, SC 29512-2495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 13/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000157262 | UNISON (01) | SC |
003604 | (05) | SC |
0204147 | GHI/PPO (01) | SC |
407690 | WELLCARE (01) | SC |
5953112 | AETNA (01) | SC |
89065X7 | (05) | NC |
F22531 | (02) | SC |