Individual provider · Type 1 NPI

Mary Crumbliss, MSN, CPNP-PC

Nurse Practitioner · Johns Creek, GA

NPI number 1144825415 Active

Practice location

10710 Medlock Bridge Rd Ste 250
Johns Creek, GA 30097-1999

Fax (770) 870-1086

Other practice locations

  • 388 Fox Trot Trl, Ringgold, GA 30736-7367 · (423) 838-3300

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XRN298923 (GA)
Pediatric Nurse Practitioner 363LP0200XAPN0000028490 (TN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1144825415

Mary Crumbliss, MSN, CPNP-PC's National Provider Identifier is 1144825415, issued on Dec 3, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Johns Creek, GA. The record was last updated on Apr 23, 2026.