MEDICARE: DR. NANCY K CROTTY MD

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	174400000X	Specialist	MD00016652	WA

General Provider Information

NPI Number	:	1760506406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY K CROTTY MD

Provider Business Mailing Address
First Line	:	502 E BOONE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99258-2506
Country	:	US
Telephone Number	:	509-323-4052
Fax Number	:	509-323-5516

Provider Business Practice Location Address
First Line	:	704 E SHARP AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99258-0001
Country	:	US
Telephone Number	:	509-323-4052
Fax Number	:	509-323-5516

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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