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General NPI Number Information
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NPI Number | 1811725849
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Entity Type | Individual
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Provider Name | MS. MARCIA CROSSON
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 901 TOWER DR STE 420
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City | TROY
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State | MI
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Zip | 48098-2827
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Country | US
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Telephone | 888-523-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 522 E E ST
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4025
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Country | US
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Telephone | 906-396-8520
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | 4704227759
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License Number State | MI
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