Provider Demographics
NPI:1558148593
Name:CROWLEY, THOMAS (FNP-BC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4956
Mailing Address - Country:US
Mailing Address - Phone:812-230-5593
Mailing Address - Fax:
Practice Address - Street 1:1711 N 6TH 1/2 ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2700
Practice Address - Country:US
Practice Address - Phone:812-238-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014297A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily