Provider Demographics
NPI:1275016016
Name:CROW, DANNIELLE LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:LEE
Last Name:CROW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANNIELLE
Other - Middle Name:LEE
Other - Last Name:CROKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-8203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5203
Practice Address - Country:US
Practice Address - Phone:508-344-2305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA8563363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical