Provider Demographics
NPI:1487653242
Name:CROWL, AUDREY RENEE (APRN)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:RENEE
Last Name:CROWL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 N MAIN ST
Mailing Address - Street 2:PO BOX 517
Mailing Address - City:SALEM
Mailing Address - State:AR
Mailing Address - Zip Code:72576-9451
Mailing Address - Country:US
Mailing Address - Phone:870-895-2152
Mailing Address - Fax:870-895-2481
Practice Address - Street 1:679 N MAIN ST
Practice Address - Street 2:NORTH ARKANSAS FAMILY CLINIC
Practice Address - City:SALEM
Practice Address - State:AR
Practice Address - Zip Code:72576-9451
Practice Address - Country:US
Practice Address - Phone:870-895-2152
Practice Address - Fax:870-895-2481
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAPN1006363LF0000X
ARA01006363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology