Gerald Thomas Crollard, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

521295 Issued in CA

Practice address

Naval Hospital Camp Pendleton
Box 555191
Camp Pendleton, CA 92055-5191

Phone

(760) 725-1511

NPI assigned

Mar 21, 2006

Last updated

Nov 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jerry Thomas Crollard Other name

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1730148461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 CAMINO PLAYA CARMEL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921244141",
            "telephone_number": "858-427-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CAMP PENDLETON",
            "address_2": "BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLLARD",
        "first_name": "GERALD",
        "middle_name": "THOMAS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "521295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "CROLLARD",
            "middle_name": "THOMAS",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Thomas Concannon Cote, SOIDC
• Michael Jack Coulter, M.D.
• Kelly Hale Court, PSYD
• Darren Joseph Couture, CRNA
• Alissa Cramer, COTA/L
• Linda Marie Crowell, LPT
• Shawn K Crowther, CERT. NURSE MIDWIFE
• Luis Robinson Ang Cruz, PHARMD
• Jessica Nicole Cubillos, DO
• Eric Edward Cunha, PH.D.

• Medical-Surgical Registered Nurse in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.