Provider Demographics
NPI:1891773073
Name:CHRISTIAN, ROSE CROWLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:CROWLEY
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:ANNE
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1063
Mailing Address - Street 2:FLETCHER ALLEN HEALTH CARE
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05402-1063
Mailing Address - Country:US
Mailing Address - Phone:802-847-4576
Mailing Address - Fax:802-847-2226
Practice Address - Street 1:1 S PROSPECT ST
Practice Address - Street 2:DEPT OF ENDOCRINOLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3456
Practice Address - Country:US
Practice Address - Phone:802-847-4576
Practice Address - Fax:802-847-2226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011777Medicaid
VTVN3827Medicare ID - Type Unspecified
E03526Medicare UPIN