Provider Demographics
NPI:1710158050
Name:CREWS, PATRICIA LYNN (AUD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:CREWS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 ISAACS ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-6096
Mailing Address - Country:US
Mailing Address - Phone:479-750-2080
Mailing Address - Fax:479-750-2080
Practice Address - Street 1:6823 ISAACS ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6096
Practice Address - Country:US
Practice Address - Phone:479-750-2080
Practice Address - Fax:479-750-2080
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA-186231H00000X
TX80364231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB116309Medicare PIN