Provider Demographics
NPI:1003491614
Name:CROWE, KELLI A (FNP-C)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:A
Last Name:CROWE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:A
Other - Last Name:WOODFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:1702 N KINGSHIGHWAY ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2122
Practice Address - Country:US
Practice Address - Phone:573-339-2000
Practice Address - Fax:573-339-1876
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021004381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily