Provider Demographics
NPI:1457066961
Name:CROWE, ELIZABETH MICHELLE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MICHELLE
Last Name:CROWE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 BOTTO LN
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:KY
Mailing Address - Zip Code:40107-8567
Mailing Address - Country:US
Mailing Address - Phone:270-401-3788
Mailing Address - Fax:
Practice Address - Street 1:153 BOTTO LN
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:KY
Practice Address - Zip Code:40107-8567
Practice Address - Country:US
Practice Address - Phone:270-401-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018903363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health