Provider Demographics
NPI:1659176279
Name:CROWLEY, CHRISTIAN LUKE
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LUKE
Last Name:CROWLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 E LYDIA HWY
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-7244
Mailing Address - Country:US
Mailing Address - Phone:843-601-3306
Mailing Address - Fax:
Practice Address - Street 1:1621 E LYDIA HWY
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-7244
Practice Address - Country:US
Practice Address - Phone:843-601-3306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide