Healthcare Provider Details

I. General information

NPI: 1043140924
Provider Name (Legal Business Name): JOAN LORETTA CROWLEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AIRPORT RD
KINSTON NC
28501-1604
US

IV. Provider business mailing address

210 TOWNE VILLAGE DR
CARY NC
27513-8910
US

V. Phone/Fax

Practice location:
  • Phone: 252-522-7000
  • Fax:
Mailing address:
  • Phone: 585-704-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: