Individual
VANESSA RENEE CROWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
355 W 16TH ST STE 3000, INDIANAPOLIS, IN 46202-2207
(317) 963-7082
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003438A
IN
363AM0700X
Medical Physician Assistant
10003438A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430D26
MEDICARE
IN
05
—
300056692
—
IN
Enumeration date
06/22/2020
Last updated
12/27/2022
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