Provider Demographics
NPI:1316143258
Name:NANCY A CRUMMEL, MSN, FNP, PC
Entity type:Organization
Organization Name:NANCY A CRUMMEL, MSN, FNP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CRUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:231-932-1942
Mailing Address - Street 1:5231 ARLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7933
Mailing Address - Country:US
Mailing Address - Phone:231-932-1942
Mailing Address - Fax:
Practice Address - Street 1:5231 ARLINGTON LN
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7933
Practice Address - Country:US
Practice Address - Phone:231-932-1942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINC114336261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care