Healthcare Provider Details

I. General information

NPI: 1619455052
Provider Name (Legal Business Name): ASIA S STARWOOD CROCKETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASIA STARWOOD CROCKETT NP

II. Dates (important events)

Enumeration Date: 07/28/2018
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18901 GREENWELL SPRINGS RD
GREENWELL SPRINGS LA
70739-4836
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-924-9985
  • Fax: 225-924-0884
Mailing address:
  • Phone: 225-924-9985
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP10017
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10017
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: