Provider Demographics
NPI:1346709128
Name:CROW, KRISTEN NICOLE IGNASZEWSKI (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NICOLE IGNASZEWSKI
Last Name:CROW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S HOWARD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2412
Mailing Address - Country:US
Mailing Address - Phone:813-258-2918
Mailing Address - Fax:132-582-9308
Practice Address - Street 1:609 S HOWARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-258-2918
Practice Address - Fax:813-258-2930
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34729225100000X
NC17387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist