Provider Demographics
NPI:1982813903
Name:CROW, LAURA LYNNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNNE
Last Name:CROW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9918 BALAYE RUN DR APT 103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7656
Mailing Address - Country:US
Mailing Address - Phone:813-830-2080
Mailing Address - Fax:
Practice Address - Street 1:9504 E COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7715
Practice Address - Country:US
Practice Address - Phone:813-664-4100
Practice Address - Fax:813-664-4117
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3095172163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent