Provider Demographics
NPI:1518267822
Name:CROW, BOB (BS, BSN, RN, DC, FNP)
Entity Type:Individual
Prefix:DR
First Name:BOB
Middle Name:
Last Name:CROW
Suffix:
Gender:M
Credentials:BS, BSN, RN, DC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17021 LAKESIDE HILLS PLZ STE 203
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2390
Mailing Address - Country:US
Mailing Address - Phone:402-235-4700
Mailing Address - Fax:
Practice Address - Street 1:8005 FARNAM DR STE 305
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3426
Practice Address - Country:US
Practice Address - Phone:402-390-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105360111N00000X
NE144212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor