Provider Demographics
NPI:1184912552
Name:CROOMS, TOWANNA SHEA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:TOWANNA
Middle Name:SHEA
Last Name:CROOMS
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:PO BOX 6289
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-6289
Mailing Address - Country:US
Mailing Address - Phone:334-699-3320
Mailing Address - Fax:334-699-3342
Practice Address - Street 1:1369 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1309
Practice Address - Country:US
Practice Address - Phone:334-699-3320
Practice Address - Fax:334-699-3342
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-052649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily