Healthcare Provider Details
I. General information
NPI: 1780545954
Provider Name (Legal Business Name): CROCKER PSYCHIATRY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3106 INGERSOLL AVE STE 116
DES MOINES IA
50312-3910
US
IV. Provider business mailing address
3106 INGERSOLL AVE STE 116
DES MOINES IA
50312-3910
US
V. Phone/Fax
- Phone: 515-220-2036
- Fax: 713-370-6607
- Phone: 515-220-2036
- Fax: 713-370-6607
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HANNAH
BECKER
CROCKER
Title or Position: PROVIDER
Credential: ARNP, PMHNP-BC
Phone: 515-229-2223