Provider Demographics
NPI:1609225101
Name:CRUTCHER, JHASMUN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JHASMUN
Middle Name:
Last Name:CRUTCHER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 S HAMPTON RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-3000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2909 S HAMPTON RD
Practice Address - Street 2:SUITE 107
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-3000
Practice Address - Country:US
Practice Address - Phone:214-467-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily