Provider Demographics
NPI:1124916291
Name:CROWDELL, JOHN PATRICK
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:CROWDELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:BENEDICT
Mailing Address - State:NE
Mailing Address - Zip Code:68316-0044
Mailing Address - Country:US
Mailing Address - Phone:402-732-6609
Mailing Address - Fax:
Practice Address - Street 1:204 LOVENA AVE
Practice Address - Street 2:
Practice Address - City:BENEDICT
Practice Address - State:NE
Practice Address - Zip Code:68316-9090
Practice Address - Country:US
Practice Address - Phone:402-732-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider