MEDICARE: JOSEPH PATRICK CROWLEY

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN0996727NP	CO

General Provider Information

NPI Number	:	1093330375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH PATRICK CROWLEY

Provider Business Mailing Address
First Line	:	10778 HILLSBORO ST
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-3793
Country	:	US
Telephone Number	:	720-369-9477
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 S CHERRY ST STE 620
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-1233
Country	:	US
Telephone Number	:	480-626-7584
Fax Number	:

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

Provider Enumeration Date	:	06/11/2020
Last Update Date	:	10/05/2021

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