Provider Demographics
NPI:1689661993
Name:CROWLEY, JUDITH M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:M
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 BROOK MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4246
Mailing Address - Country:US
Mailing Address - Phone:512-331-7156
Mailing Address - Fax:
Practice Address - Street 1:511 OAKWOOD BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4007
Practice Address - Country:US
Practice Address - Phone:512-388-7088
Practice Address - Fax:512-388-0699
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529524367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088538603Medicaid