Provider Demographics
NPI:1679877625
Name:CROWNOVER-INCH, LINDA MARIE (DOULA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:CROWNOVER-INCH
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W 16TH ST APT 412
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-3673
Mailing Address - Country:US
Mailing Address - Phone:309-737-9255
Mailing Address - Fax:
Practice Address - Street 1:1420 W 16TH STREET,
Practice Address - Street 2:#412
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804
Practice Address - Country:US
Practice Address - Phone:309-737-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula