Healthcare Provider Details

I. General information

NPI: 1477197556
Provider Name (Legal Business Name): ASHLEY NICHOLE CROWDER AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4226 W US HIGHWAY 64-ALT
MURPHY NC
28906-8122
US

IV. Provider business mailing address

PO BOX 100181
COLUMBIA SC
29202-3141
US

V. Phone/Fax

Practice location:
  • Phone: 828-479-6434
  • Fax:
Mailing address:
  • Phone: 828-202-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012278
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5012278
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5012278
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5012278
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: