Provider Demographics
NPI:1457435687
Name:CROWELL, REBA E (ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:REBA
Middle Name:E
Last Name:CROWELL
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10435 STATE ROUTE 127
Mailing Address - Street 2:
Mailing Address - City:WEST MANCHETER
Mailing Address - State:OH
Mailing Address - Zip Code:45382
Mailing Address - Country:US
Mailing Address - Phone:937-262-3390
Mailing Address - Fax:937-267-5382
Practice Address - Street 1:4100 WEST 3RD STREET
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:937-267-5382
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNP-07852363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health