MEDICARE: JESSICA CROWE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	RN172742	AZ

General Provider Information

NPI Number	:	1053260117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CROWE

Provider Business Mailing Address
First Line	:	2357 E WALNUT RD
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85298-6120
Country	:	US
Telephone Number	:	602-535-3382
Fax Number	:

Provider Business Practice Location Address
First Line	:	2357 E WALNUT RD
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85298-6120
Country	:	US
Telephone Number	:	480-430-7751
Fax Number	:	480-430-7751

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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