Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN195407 | GA |
NPI | 1154777563 |
---|---|
Provider Name | Lindsay Crowe |
First Address | Marietta, GA 30062-5939 |
Second Address | Chattanooga, TN 37404-3258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2016 |
Last Update Date | 05/05/2016 |