Provider Demographics
NPI:1518055268
Name:CROWLEY, BRICE CLIFTON (LPN)
Entity Type:Individual
Prefix:
First Name:BRICE
Middle Name:CLIFTON
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:BRICE
Other - Middle Name:CLIFTON
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4201 TUDOR CENTRE DR
Mailing Address - Street 2:SUITE #320
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5904
Mailing Address - Country:US
Mailing Address - Phone:907-729-8624
Mailing Address - Fax:907-729-8607
Practice Address - Street 1:225 EAGLE ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2626
Practice Address - Country:US
Practice Address - Phone:907-729-8624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK5949164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse