=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447075320
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAZMINE MONIQUE CROWE PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2024
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2086 JODECO ROAD #1540
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-385-2690
-----------------------------------------------------
Fax | 470-275-0696
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 998 HIGHWAY 19 41 UNIT 1431
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30228-3662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-385-2690
-----------------------------------------------------
Fax | 470-275-0696
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 277276
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------