Provider Demographics
NPI:1366214546
Name:KATIE CROW, LLC
Entity type:Organization
Organization Name:KATIE CROW, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-543-3965
Mailing Address - Street 1:2905 GOODELLS RD
Mailing Address - Street 2:
Mailing Address - City:GOODELLS
Mailing Address - State:MI
Mailing Address - Zip Code:48027-1410
Mailing Address - Country:US
Mailing Address - Phone:810-543-3965
Mailing Address - Fax:
Practice Address - Street 1:2905 GOODELLS RD
Practice Address - Street 2:
Practice Address - City:GOODELLS
Practice Address - State:MI
Practice Address - Zip Code:48027-1410
Practice Address - Country:US
Practice Address - Phone:810-543-3965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty