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Individual

JENNIFER A CROWNHART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1020 N. SAN FRANCISCO ST., FLAGSTAFF, AZ 86001
(928) 699-9448
Mailing address
1780 E APPALACHIAN RD, FLAGSTAFF, AZ 86004-1718
(928) 699-9448

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN097480
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
394974
AZ
01
430053651
RAIL ROAD MEDICARE
AZ
01
AZ0090910
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
10/20/2006
Last updated
05/12/2008
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