Provider Demographics
NPI:1366073454
Name:CROWE, REBECCA G
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:G
Last Name:CROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 PROVIDENCE CIR
Mailing Address - Street 2:
Mailing Address - City:STATHAM
Mailing Address - State:GA
Mailing Address - Zip Code:30666-2131
Mailing Address - Country:US
Mailing Address - Phone:404-931-6488
Mailing Address - Fax:
Practice Address - Street 1:516 PROVIDENCE CIR
Practice Address - Street 2:
Practice Address - City:STATHAM
Practice Address - State:GA
Practice Address - Zip Code:30666-2131
Practice Address - Country:US
Practice Address - Phone:404-931-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula