Provider Demographics
NPI:1336930205
Name:CROWLEY, JASMINE IRENE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:IRENE
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:IRENE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8095 COYLE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-2448
Mailing Address - Country:US
Mailing Address - Phone:313-205-8894
Mailing Address - Fax:
Practice Address - Street 1:8095 COYLE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-2448
Practice Address - Country:US
Practice Address - Phone:313-205-8894
Practice Address - Fax:313-205-8894
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health