MEDICARE: JAZMINE MONIQUE CROWE PMHNP

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	277276	GA

General Provider Information

NPI Number	:	1447075320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMINE MONIQUE CROWE PMHNP

Provider Business Mailing Address
First Line	:	998 HIGHWAY 19 41 UNIT 1431
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-3662
Country	:	US
Telephone Number	:	470-385-2690
Fax Number	:	470-275-0696

Provider Business Practice Location Address
First Line	:	2086 JODECO ROAD #1540
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228
Country	:	US
Telephone Number	:	470-385-2690
Fax Number	:	470-275-0696

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	06/01/2026

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