Individual provider · Type 1 NPI

Elizabeth Lee Crockett, PA

Medical Physician Assistant · Virginia Beach, VA

NPI number 1306106190 Active

Practice location

4092 Foxwood Dr, Ste 101
Virginia Beach, VA 23462-5225

Call (757) 686-3508 Map

Fax (757) 686-0541

Mailing address

PO Box 7549
Portsmouth, VA 23707-0549

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X0110003870 (VA)

Medical Physician Assistant: Definition to come...

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About NPI 1306106190

Elizabeth Lee Crockett, PA's National Provider Identifier is 1306106190, issued on May 25, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Virginia Beach, VA. The record was last updated on May 25, 2012.