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General NPI Number Information
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NPI Number | 1184912552
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Entity Type | Individual
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Provider Name | TOWANNA SHEA CROOMS CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 1369 W MAIN ST
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City | DOTHAN
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State | AL
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Zip | 36301-1309
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Country | US
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Telephone | 334-699-3320
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Fax | 334-699-3342
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Provider Business Mailing Address
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Address Line | PO BOX 6289
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City | DOTHAN
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State | AL
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Zip | 36302-6289
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Country | US
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Telephone | 334-699-3320
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Fax | 334-699-3342
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-052649
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License Number State | AL
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