Provider Demographics
NPI:1922541291
Name:CROW, RUBY L (CRNP)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:L
Last Name:CROW
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-2130
Mailing Address - Country:US
Mailing Address - Phone:814-676-7863
Mailing Address - Fax:814-676-7975
Practice Address - Street 1:100 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2130
Practice Address - Country:US
Practice Address - Phone:814-676-7863
Practice Address - Fax:814-676-7975
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA111111363LF0000X
PASP017057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily