Provider Demographics
NPI:1134368061
Name:CRAWFORD, CATHERINE H (RN, BSN, LMT)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:H
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RN, BSN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 BROAD RUN DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6058
Mailing Address - Country:US
Mailing Address - Phone:865-982-8600
Mailing Address - Fax:
Practice Address - Street 1:1432 BROAD RUN DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6058
Practice Address - Country:US
Practice Address - Phone:865-982-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47668163W00000X
TN6975174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174400000XOther Service ProvidersSpecialist