Provider Demographics
NPI:1013387638
Name:CROLEY, ROBERT R (CARE COORDINATOR, JD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:R
Last Name:CROLEY
Suffix:
Gender:M
Credentials:CARE COORDINATOR, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E TUDOR RD STE 6
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1036
Mailing Address - Country:US
Mailing Address - Phone:907-332-0065
Mailing Address - Fax:907-782-4522
Practice Address - Street 1:1515 E TUDOR RD STE 6
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507
Practice Address - Country:US
Practice Address - Phone:907-332-0065
Practice Address - Fax:907-782-4522
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator