Abbin Ethan Crandell, RN, CDCES

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RN9356329 Issued in FL

Practice address

19 Riverdale LN
Palm Coast, FL 32164-3414

Phone

(904) 329-5140

NPI assigned

Feb 28, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1528825395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 RIVERDALE LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643414",
            "telephone_number": "904-329-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 RIVERDALE LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321643414",
            "telephone_number": "904-329-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDELL",
        "first_name": "ABBIN",
        "middle_name": "ETHAN",
        "name_prefix": "Mr.",
        "credential": "RN, CDCES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9356329",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "RN9356329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Cosgrove, BCBA
• Termieka Cox, CNA
• CR Loving Care
• CR Loving Care, Inc.
• Stephanie Elaine Crandall, DPT
• Elizabeth Ann Craun
• Timothy Crenshaw
• CRH MQ LLC
• Savannah Crist Munier
• Alicia Critcher, ARNP

• Diabetes Educator Registered Nurse in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Diabetes Educator Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.