Individual
MALLORY GAIL CROWNOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
147 S 52ND PL, SPRINGFIELD, OR 97478-6210
(541) 746-1166
(541) 393-1607
Mailing address
147 S 52ND PL, SPRINGFIELD, OR 97478-6210
(541) 746-1166
(541) 393-1607
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201710156NP-PP
OR
363L00000X
Nurse Practitioner
ARNP9344290
FL
Other
Enumeration date
11/29/2017
Last updated
03/17/2018
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