Most Relevant Information
Provider Data
| NPI Number: | 1003344854 |
| Provider Name: | MIASHA RENEE CRUTCHFIELD APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3011268 |
Most Important Dates
| Enumeration Date: | 05/24/2017 |
| Last Updated: | 02/13/2023 |
Provider Practice Location
3015 WILSON AVE
LOUISVILLE
KY
402111969
Practice Location Phone/Fax
| Phone: | 5027744401 |
| Fax: |
Provider Mailing Location
3015 WILSON AVE
LOUISVILLE
KY
402111969
Provider Mailing Phone/Fax
| Phone: | 5027744401 |
| Fax: |