Kimberley Anne Crawford, PHD, MPH, RN, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Clarkston, GA

NPI 1013792852 · NPPES record last updated Aug 29, 2023

Key facts

NPI
1013792852
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN139443 (GA)
Practice address
3700 Market St Ste E-1
Clarkston, GA 30021-2653
Phone
(678) 898-5731
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN139443GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkston Community Health Center, Inc. Past
since Sep 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN139443 GA Yes

Addresses

Primary practice location

3700 Market St Ste E-1
Clarkston, GA 30021-2653

Mailing address

130 4TH Ave SE
Atlanta, GA 30317-2724
Phone (404) 371-9407

Other providers in Clarkston, GA

All providers in Clarkston, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.