Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5009140 | NC |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 5009140 | NC |
NPI | 1073517041 |
---|---|
Provider Name | Mrs. Malorie Susan Crawford |
First Address | Lenoir, NC 28645-5703 |
Second Address | Lenoir, NC 28645-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 17/03/2021 |