Hayley Michelle Crandall, IDMT

Individual provider Active NPI Independent Duty Corpsman · Holloman Afb, NM

NPI 1467686154 · NPPES record last updated Apr 30, 2018

Key facts

NPI
1467686154
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
49TH Medical Group/SGPF
280 First Street, BLDG 23
Holloman Afb, NM 88330-8273
Phone
(575) 572-2446
Fax
(575) 572-2259
NPI assigned
May 8, 2009
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes
Independent Duty Medical Technicians 1710I1003X

Addresses

Primary practice location

49TH Medical Group/SGPF
280 First Street, BLDG 23
Holloman Afb, NM 88330-8273

Mailing address

49TH Medical Group/SGPF
280 First Street, BLDG 23
Holloman Afb, NM 88330-8273
Phone (575) 572-2446

Other providers in Holloman Afb, NM

All providers in Holloman Afb, NM · Independent Duty Corpsman in New Mexico

Sources for this page

Verify at the official NPI Registry.