Provider Demographics
NPI:1447702485
Name:CROWE, CAROL L (FNP NP-C PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:CROWE
Suffix:
Gender:F
Credentials:FNP NP-C PMHNP-BC
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:L
Other - Last Name:GODT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-0395
Mailing Address - Country:US
Mailing Address - Phone:503-791-3355
Mailing Address - Fax:541-214-9642
Practice Address - Street 1:139 S MAIN AVENUE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146
Practice Address - Country:US
Practice Address - Phone:503-791-3355
Practice Address - Fax:541-314-9642
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201608016NP-PP363LF0000X, 2084P0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry