Provider Demographics
NPI:1407588643
Name:CROWE, MEGAN RENEE (PMHNPBC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:RENEE
Last Name:CROWE
Suffix:
Gender:F
Credentials:PMHNPBC
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:RENEE
Other - Last Name:KERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:106 S FARRAR DR STE 109
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4912
Mailing Address - Country:US
Mailing Address - Phone:573-334-7055
Mailing Address - Fax:573-334-7961
Practice Address - Street 1:106 S FARRAR DR STE 109
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4912
Practice Address - Country:US
Practice Address - Phone:573-334-7055
Practice Address - Fax:573-334-7961
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015023323163WP0808X
MO2022025020363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health