Healthcare Provider Details

I. General information

NPI: 1053181982
Provider Name (Legal Business Name): DANIEL CROWELL MSN-PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8069 HIGHWAY 41A
CEDAR HILL TN
37032-6617
US

IV. Provider business mailing address

8069 HIGHWAY 41A
CEDAR HILL TN
37032-6617
US

V. Phone/Fax

Practice location:
  • Phone: 615-992-5932
  • Fax:
Mailing address:
  • Phone: 615-992-5932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number181276
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number36603
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: