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Individual

NICOLE CROWDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3490
(540) 725-5069
Mailing address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3490
(540) 725-5069

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001214090
VA
363LF0000X
Family Nurse Practitioner
Primary
F0516010
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437506789
VA
Enumeration date
05/17/2016
Last updated
12/13/2016
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