Healthcare Provider Details

I. General information

NPI: 1295304145
Provider Name (Legal Business Name): HEATHER LYNN CROW CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MORRIS ST
CHARLESTON WV
25301-1326
US

IV. Provider business mailing address

PO BOX 3466
CHARLESTON WV
25334-3466
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-6220
  • Fax:
Mailing address:
  • Phone: 304-720-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number132378
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number109977
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: