MEDICARE: MRS. ASHLEY MICHELLE CROW LPN

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	164W00000X	Licensed Practical Nurse	98631	TN

General Provider Information

NPI Number	:	1972299824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MICHELLE CROW LPN

Provider Business Mailing Address
First Line	:	162 COUNTY SERVICES DR
Second Line	:
City	:	ASHLAND CITY
State	:	TN
Zip	:	37015-1748
Country	:	US
Telephone Number	:	615-792-4318
Fax Number	:

Provider Business Practice Location Address
First Line	:	879 WHITE OAK FLATT RD
Second Line	:
City	:	CHARLOTTE
State	:	TN
Zip	:	37036-5524
Country	:	US
Telephone Number	:	615-282-9851
Fax Number	:

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

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	04/13/2023

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