Healthcare Provider Details

I. General information

NPI: 1568397743
Provider Name (Legal Business Name): REBECCA CROWDER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S SHIELDS ST BLDG H
FORT COLLINS CO
80526-1827
US

IV. Provider business mailing address

2001 S SHIELDS ST BLDG H
FORT COLLINS CO
80526-1827
US

V. Phone/Fax

Practice location:
  • Phone: 970-893-7621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0001390
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: