Active NPI
Tamra Ruth MC Millan Crowell, LPN
- Licensed Practical Nurse
- Blytheville, AR
National Provider Identifier
1124156104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 176888
- Practice address
- 1510 Byrum Rd
Blytheville, AR 72315-8033 - Phone
- (870) 532-2600
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 176888 | AR | Primary |
Addresses
Primary practice location
1510 Byrum Rd
Blytheville, AR 72315-8033
Mailing address
407 W Lake St
Manila, AR 72442-8002
Phone (870) 561-1011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 176888 | AR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124156104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 W LAKE ST",
"city": "MANILA",
"state": "AR",
"postal_code": "724428002",
"telephone_number": "870-561-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 BYRUM RD",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723158033",
"telephone_number": "870-532-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MC MILLAN CROWELL",
"first_name": "TAMRA",
"middle_name": "RUTH",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AR",
"license": "176888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blytheville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.