Provider Demographics
NPI:1255533683
Name:CRABTREE, STEPHANIE BROOKE (MD)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BROOKE
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1010 CARONDELET DR
Mailing Address - Street 2:SUITE 224A
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4859
Mailing Address - Country:US
Mailing Address - Phone:816-943-0706
Mailing Address - Fax:816-943-6122
Practice Address - Street 1:1010 CARONDELET DR
Practice Address - Street 2:SUITE 224A
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4859
Practice Address - Country:US
Practice Address - Phone:816-943-0706
Practice Address - Fax:816-943-6122
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011011562207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine