Provider Demographics
NPI:1760159156
Name:CROWE, CAITLIN JEAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:JEAN
Last Name:CROWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:JEAN
Other - Last Name:SCHIRMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157
Mailing Address - Country:US
Mailing Address - Phone:336-903-7900
Mailing Address - Fax:336-713-5445
Practice Address - Street 1:1370 W D ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3506
Practice Address - Country:US
Practice Address - Phone:336-903-7900
Practice Address - Fax:336-713-5445
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11312363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant