Healthcare Provider Details

I. General information

NPI: 1780137422
Provider Name (Legal Business Name): EILEEN MARY CROWLEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 WHIPPOORWILL LN
NAPLES FL
34105-3847
US

IV. Provider business mailing address

331 HIGHLAND AVE
SALEM MA
01970-7006
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8490
  • Fax:
Mailing address:
  • Phone: 978-745-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number171235
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11012326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: