Provider Demographics
NPI:1235319765
Name:CROWELL, LINDA MARIE (LPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:CROWELL
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CAMP PENDLETON BUILDING H-T-200
Mailing Address - Street 2:
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92057
Mailing Address - Country:US
Mailing Address - Phone:760-725-0063
Mailing Address - Fax:
Practice Address - Street 1:NAVY HOSPITAL CAMP PENDLETON
Practice Address - Street 2:BUILDING H-T- 200
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-1319
Practice Address - Country:US
Practice Address - Phone:760-725-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27548167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician