Lerryn U Crocker, ADN BSN MSN FNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Hilton Head Island, SC
NPI 1891785523 · NPPES record last updated May 20, 2019
Key facts
- NPI
- 1891785523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 22182 (SC)
- Practice address
- 25 Hospital Center Blvd
Hilton Head Island, SC 29926-2738 - Phone
- (843) 784-8224
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- Sole proprietor
- No
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)
- Yes
- Credentials
- Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN059534 CNS/PMH NP | GA | MD | Family Nurse Practitioner |
| 22182 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Mountains Community Services | Past | Accepting new patients | |
| Family Practice of Habersham PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN059534 CNS/PMH NP | GA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN059534 CNS/PMH NP | GA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 22182 | SC | Yes |
Addresses
Primary practice location
25 Hospital Center Blvd
Hilton Head Island, SC 29926-2738
Mailing address
4331 Thurmond Tanner Rd
Flowery Branch, GA 30542
Phone (678) 513-5733
Other practice location 1
4331 Thurmond Tanner Rd
Flowery Branch, GA 30542
Phone (678) 513-5733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000970109A | Medicaid | GA | |
| 00970109A | Medicaid | GA |
Other providers in Hilton Head Island, SC
- Susan Hale Couzens
- Callie Covington
- Craig W Jackson DDS
- Maci Shaw Craine
- Lindsey K Crawford
- Ashley Cubbage
- CVS Pharmacy
- Bennie Clark Dalton
- Dale Patrick Daly
- Mary Elizabeth Daniels
All providers in Hilton Head Island, SC · Psychiatric/Mental Health Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2019. 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.