Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 619 | TN |
N | 2081S0010X | Sports Medicine | 619 | TN |
N | 213ES0000X | Sports Medicine | 619 | TN |
Y | 213ES0103X | Foot & Ankle Surgery | 619 | TN |
NPI | 1457547283 |
---|---|
Provider Name | Mrs. Larelyn T Crear |
First Address | Murfreesboro, TN 37129-0032 |
Second Address | Nashville, TN 37228-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2007 |
Last Update Date | 27/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3353911 | (05) | TN |
U95795 | (02) | TN |