Charles Crocker, NP
Individual provider Active NPI Family Nurse Practitioner · Colonial Beach, VA
NPI 1043095276 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1043095276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024180587 (VA)
- Practice address
- 5 Irving Ave
Colonial Beach, VA 22443-2411 - Phone
- (804) 224-0571
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024180587 | VA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024180587 | VA | Yes |
Addresses
Primary practice location
5 Irving Ave
Colonial Beach, VA 22443-2411
Mailing address
PO Box 275
Colonial Beach, VA 22443-0275
Other providers in Colonial Beach, VA
- Mark K Arness
- Beachgate Family Medical Center LLC
- Colonial Beach Medical Center
- Colonial Beach Public Schools
- Colonial Beach Rescue Squad Incorporated
- Ashley Curry
- East Coast Physicians PC
- Norman B Ellis
- Hasan Farkhani
- Worthington H Freeman
All providers in Colonial Beach, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.