Provider Demographics
NPI:1568587574
Name:CROWLEY, MOUSUMI (RN)
Entity Type:Individual
Prefix:
First Name:MOUSUMI
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MOUSUMI
Other - Middle Name:
Other - Last Name:MUKHERJEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3104 O ST
Mailing Address - Street 2:#363
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6519
Mailing Address - Country:US
Mailing Address - Phone:727-495-6683
Mailing Address - Fax:
Practice Address - Street 1:3104 O ST
Practice Address - Street 2:#363
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6519
Practice Address - Country:US
Practice Address - Phone:727-495-6683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL41332552163W00000X
TN148619163W00000X
FL9246047163W00000X
CA846929163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse