Provider Demographics
NPI:1629386685
Name:CROWDY, CRISTA STRAWZELL (P A)
Entity Type:Individual
Prefix:MRS
First Name:CRISTA
Middle Name:STRAWZELL
Last Name:CROWDY
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1210 KY HIGHWAY 36E
Mailing Address - Street 2:2C
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7492
Mailing Address - Country:US
Mailing Address - Phone:859-234-6000
Mailing Address - Fax:
Practice Address - Street 1:1210 KY HIGHWAY 36E
Practice Address - Street 2:2C
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7492
Practice Address - Country:US
Practice Address - Phone:859-234-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPENDINGMedicare PIN