Provider Demographics
NPI:1841274941
Name:CROSBY, SUSAN KATHERINE (APRN,PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KATHERINE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:APRN,PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 GOLF DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-3900
Mailing Address - Country:US
Mailing Address - Phone:928-853-8410
Mailing Address - Fax:
Practice Address - Street 1:2626 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-691-2024
Practice Address - Fax:325-690-5241
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX598136363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health