Healthcare Provider Details

I. General information

NPI: 1447075320
Provider Name (Legal Business Name): JAZMINE MONIQUE CROWE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2086 JODECO ROAD #1540
HAMPTON GA
30228
US

IV. Provider business mailing address

998 HIGHWAY 19 41 UNIT 1431
HAMPTON GA
30228-3662
US

V. Phone/Fax

Practice location:
  • Phone: 470-385-2690
  • Fax: 470-275-0696
Mailing address:
  • Phone: 470-385-2690
  • Fax: 470-275-0696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277276
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: