| NPI | 1376039057 |
|---|---|
| Former Name | JACY KATHLEEN CROWL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 250278) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK 106718) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2021-01-26 |