Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MD30506 | TN |
Y | 2084N0400X | Neurologist | MD30506 | TN |
NPI | 1124058532 |
---|---|
Provider Name | Jacqueline Crawford |
First Address | Knoxville, TN 37934-1922 |
Second Address | Knoxville, TN 37934-1922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 22/07/2010 |