Provider Demographics
NPI:1285201004
Name:CROWELL, LAURA ANNE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:CROWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 BEATTY DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9654
Mailing Address - Country:US
Mailing Address - Phone:419-822-6286
Mailing Address - Fax:
Practice Address - Street 1:5351 MITCHAW RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9406
Practice Address - Country:US
Practice Address - Phone:419-824-6699
Practice Address - Fax:419-824-6698
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN257022163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology