Provider Demographics
NPI:1871651356
Name:CROWLEY, CELESTE (NP)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 NEW DRIFTWAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4533
Mailing Address - Country:US
Mailing Address - Phone:781-545-7243
Mailing Address - Fax:781-210-2854
Practice Address - Street 1:56 NEW DRIFTWAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4533
Practice Address - Country:US
Practice Address - Phone:781-545-7243
Practice Address - Fax:781-210-2854
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4534Medicare PIN
MAQ13185Medicare UPIN