Provider Demographics
NPI:1487643755
Name:CROWLEY, KAREN R (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:R
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5509
Mailing Address - Country:US
Mailing Address - Phone:781-388-4160
Mailing Address - Fax:781-397-8715
Practice Address - Street 1:109 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5509
Practice Address - Country:US
Practice Address - Phone:781-388-4160
Practice Address - Fax:781-397-8715
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177105NP363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0352021Medicaid
MANP2465OtherBCBS
P08643Medicare UPIN
MANP2465OtherBCBS