MEDICARE: FATIMA CROWE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	282995	SC
2	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053774323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA CROWE RN

Provider Business Mailing Address
First Line	:	5611 HAMMERMILL DR
Second Line	:
City	:	HARRISBURG
State	:	NC
Zip	:	28075-3933
Country	:	US
Telephone Number	:	336-225-6912
Fax Number	:

Provider Business Practice Location Address
First Line	:	13534 PLAZA ROAD EXT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-8921
Country	:	US
Telephone Number	:	336-225-6912
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2016
Last Update Date	:	02/11/2026

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