ROBERT DAVID CROCKETT FNP NPI 1801883475

NPI Information

NPI: 1801883475
Provider Name: ROBERT DAVID CROCKETT, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1100 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703
Phone: (615) 355-3451
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Robert David Crockett, FNP is a family nurse practitioner in Fayetteville, AR. Robert David Crockett, FNP NPI is 1801883475. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1100 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703-944
Phone: (615) 355-3451

The NPI 1801883475 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/29/2005 and was last updated on 9/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	2000160927	MISSOURI	No
2	363LF0000X	Nurse Practitioner	Family	2000160927	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	427473004	MEDICAID	MISSOURI
2	P00269324	OTHER		RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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