Healthcare Provider Details

I. General information

NPI: 1649135385
Provider Name (Legal Business Name): NATHALIE CROWLEY L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 NICOLLET AVE
MINNEAPOLIS MN
55403-3747
US

IV. Provider business mailing address

3629 MINNEHAHA AVE
MINNEAPOLIS MN
55406-2628
US

V. Phone/Fax

Practice location:
  • Phone: 612-213-0190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2135
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: