Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 71007110A | IN |
NPI | 1164961660 |
---|---|
Provider Name | Morgan D Crum |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-2479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2017 |
Last Update Date | 13/06/2017 |