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Individual

KELLY E CROWLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
12563 STATE ROAD 23, GRANGER, IN 46530-9226
(574) 335-8300
(574) 335-0775
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-8707

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012221A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102193309
ANTHEM BCBS
IN
05
300064808
IN
Enumeration date
03/08/2022
Last updated
04/06/2026
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