Individual provider · Type 1 NPI

Nicole Lynne Crockford, PA-C

Physician Assistant · Spartanburg, SC

NPI number 1265480065 Active

Practice location

2030 North Church Place
Spartanburg, SC 29303

Call (864) 582-6858 Map

Fax (864) 583-9360

Mailing address

603 Addlestone Way
Duncan, SC 29334-8963

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XA945 (SC)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1265480065

Nicole Lynne Crockford, PA-C's National Provider Identifier is 1265480065, issued on May 4, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Spartanburg, SC. The record was last updated on Jul 13, 2026.