Individual
MELISSA M CROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 PARK ST, BOWLING GREEN, KY 42101-1708
(270) 783-3343
(270) 780-0476
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1708
(270) 783-3343
(270) 780-0476
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
088778
IA
363A00000X
Physician Assistant
Primary
TC980
KY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/09/2018
Last updated
10/27/2020
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