Provider Demographics
NPI:1598744559
Name:CROWELL, ANNE M (GNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:CROWELL
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-595-2000
Mailing Address - Fax:508-853-7149
Practice Address - Street 1:630 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-595-2000
Practice Address - Fax:508-853-7149
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181423363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA3453OtherHARVARD PILGRIM
500005941OtherRAILROAD MEDICARE
NP0659OtherBLUE CARE ELECT
042472226OtherONE HEALTH PLAN
042472266OtherPRIVATE HEALTHCARE SYSTEM
702218OtherMEDICAID WELFARE
042472266OtherTRICARE CHAMPUS
MA702218Medicaid
NP0659OtherBLUE SHIELD HMO BLUE
NP0659OtherMEDICARE B
042472266OtherTHREE RIVERS
8300305OtherEVERCARE
57694OtherFALLON COMMUNITY HEALTH
S26905Medicare UPIN
042472266OtherTHREE RIVERS