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General NPI Number Information
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NPI Number | 1780099853
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Entity Type | Organization
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Legal Business Name | CROWLEY PRIMARY CARE, LLC
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 1325 WRIGHT AVE STE A
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City | CROWLEY
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State | LA
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Zip | 70526-2226
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Country | US
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Telephone | 337-788-3032
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Fax | 337-783-7009
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Provider Business Mailing Address
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Address Line | 1325 WRIGHT AVE STE A
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City | CROWLEY
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State | LA
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Zip | 70526-2226
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Country | US
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Telephone | 337-788-3032
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Fax | 337-783-7009
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Authorized Official
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Title or Position | MEMBER
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Name | NANCY BRILEY WALKER
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Credential | M.D.
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Telephone | 337-788-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200609
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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