Harold Crutcher
Individual provider Active NPI Registered Nurse · Fayetteville, TN
NPI 1598084279 · NPPES record last updated May 20, 2010
Key facts
- NPI
- 1598084279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 64190 (TN)
- Practice address
- 2241 Thornton Taylor Pkwy
Fayetteville, TN 37334-3637 - Phone
- (931) 433-6456
- NPI assigned
- May 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64190 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerstone of Tennessee, Inc. | Past |
Accepting new patients | |
| Centerstone of Tennessee, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 64190 | TN | Yes |
Addresses
Primary practice location
2241 Thornton Taylor Pkwy
Fayetteville, TN 37334-3637
Mailing address
2241 Thornton Taylor Pkwy
Fayetteville, TN 37334-3637
Other providers in Fayetteville, TN
- John C Compton
- Lorelei B Corder
- Kyle Cravey
- Crossroads Treatment Centers of Tennessee, P.C.
- David Crump
- Charles Wayne Damron
- Jimmy David Damron
- Ali Brooke Daniel
- Jimmy M Daniel
- Sandra Kilburn Daniel
All providers in Fayetteville, TN · Registered Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2010. 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.