Provider Demographics
NPI:1396209649
Name:CROSSIER, JOSE (APRN)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:CROSSIER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 NE 16TH PL UNIT 4-5
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2213
Mailing Address - Country:US
Mailing Address - Phone:239-445-3683
Mailing Address - Fax:239-829-9121
Practice Address - Street 1:514 NE 16TH PL UNIT 4-5
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2213
Practice Address - Country:US
Practice Address - Phone:239-445-3683
Practice Address - Fax:239-829-9121
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001074363LF0000X
FLAPRN11001074363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily