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General NPI Number Information
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NPI Number | 1487479812
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Entity Type | Individual
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Provider Name | JOHN CROWE RN
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Gender | Male
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 31292 ALPINE MEADOWS RD
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City | SHINGLETOWN
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State | CA
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Zip | 96088-9462
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Country | US
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Telephone | 530-474-3390
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Fax |
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Provider Business Mailing Address
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Address Line | 2039 GLENROSE DR
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City | REDDING
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State | CA
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Zip | 96001-4942
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Country | US
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Telephone | 209-289-9425
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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 | 839239
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License Number State | CA
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