Individual provider · NPI-1

Gabriel Crawford

Nurse Practitioner, Psych/Mental Health · Farmington, MO

NPI number1730546243
StatusActive
Last updated in NPPESMar 10, 2025

Details

NPI
1730546243
Entity type
Individual (NPI-1)
Name
Gabriel Crawford
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 28, 2016
Certification date
Mar 10, 2025
Last updated
Mar 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health2084P0800XMOYes
193400000X Single Specialty2084P0800XMO

Practice location

4217 Scenic View Dr
Farmington, MO 63640-7846

Phone 573-330-6468 · Fax 573-218-0716

Mailing address

4217 Scenic View Dr
Farmington, MO 63640-7846

Phone 573-330-6468

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