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Individual

ADREA MARIE CROUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477
Mailing address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-060657
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2-060657
LICENSURE
AL
Enumeration date
06/11/2021
Last updated
06/11/2021
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