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General NPI Number Information
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NPI Number | 1194878611
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Entity Type | Individual
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Provider Name | AMY L CROSON CNP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 3090 FIVE POINTS HARTFORD RD
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City | FOWLER
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State | OH
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Zip | 44418-9726
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Country | US
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Telephone | 731-394-1145
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Fax | 330-971-7256
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Provider Business Mailing Address
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Address Line | PO BOX 269084
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-9084
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Country | US
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Telephone | 731-394-1145
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 274464
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.18926
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License Number State | OH
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