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Organization
FOUR CROWNE LEGACY LLC
Active
Organization
FOUR CROWNE LEGACY LLC
Active
Other names
Crowne Initiative Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNORA BRADLEY MASON DNP, APRN, PMHNP-BC (PARTNER)
(757) 826-1300
Entity
Organization
Contact information
Practice address
6147 JEFFERSON AVE OFC 2, NEWPORT NEWS, VA 23605-1511
(757) 504-2191
Mailing address
317 PEACH TREE CRES, NEWPORT NEWS, VA 23602-7494
(757) 504-2191
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
11/24/2025
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