Healthcare Provider Details

I. General information

NPI: 1760585616
Provider Name (Legal Business Name): CAROL JEAN CROSBY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NORTH AVE
GRAND JUNCTION CO
81501-6428
US

IV. Provider business mailing address

11099 HWY 65 P.O. BOX 43
MESA CO
81643-0043
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-0731
  • Fax: 970-244-1323
Mailing address:
  • Phone: 970-268-5581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number78003
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: