Individual
COURTNIE LYN CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6780 W THUNDERBIRD RD STE A101, PEORIA, AZ 85381-5049
(028) 431-9916
Mailing address
10801 N 32ND ST APT 224, PHOENIX, AZ 85028-3242
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7578
AZ
Other
Enumeration date
09/04/2019
Last updated
09/14/2021
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