Mrs Mindy Louise Crookham, NP | |
10622 Petunia Ln, Suite D, Palo Cedro, CA 96073-9776 | |
(530) 549-4594 | |
Not Available |
Full Name | Mrs Mindy Louise Crookham |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 10622 Petunia Ln, Palo Cedro, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1467645382 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | NP14207 (California) | Primary |
Entity Name | Redding Rancheria |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104859354 PECOS PAC ID: 7810969847 Enrollment ID: O20040810001377 |
Entity Name | County Of Lake |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326252271 PECOS PAC ID: 2466495429 Enrollment ID: O20050609001101 |
Entity Name | Consolidated Tribal Health Project, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003826009 PECOS PAC ID: 1456260736 Enrollment ID: O20050714000893 |
Entity Name | County Of Modoc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396858668 PECOS PAC ID: 5193987808 Enrollment ID: O20120425000476 |
Entity Name | County Of Siskiyou |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780803239 PECOS PAC ID: 8224280706 Enrollment ID: O20121207000287 |
Mailing Address | Practice Location Address |
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Mrs Mindy Louise Crookham, NP 10622 Petunia Ln, Palo Cedro, CA 96073-9776 Ph: (530) 549-4594 | Mrs Mindy Louise Crookham, NP 10622 Petunia Ln, Suite D, Palo Cedro, CA 96073-9776 Ph: (530) 549-4594 |