Provider Demographics
NPI:1487159497
Name:CRUMLEY, KRISTEN DANIELLE (MD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DANIELLE
Last Name:CRUMLEY
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3887
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-3887
Mailing Address - Country:US
Mailing Address - Phone:479-452-9416
Mailing Address - Fax:479-242-1990
Practice Address - Street 1:5707 JENNY LIND RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-7435
Practice Address - Country:US
Practice Address - Phone:479-452-9416
Practice Address - Fax:479-242-1990
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2024-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-171342085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology