Provider Demographics
NPI:1578311643
Name:CROW, ANA N
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:N
Last Name:CROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8984
Mailing Address - Country:US
Mailing Address - Phone:919-292-2468
Mailing Address - Fax:919-292-2167
Practice Address - Street 1:1303 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-8984
Practice Address - Country:US
Practice Address - Phone:919-292-2468
Practice Address - Fax:919-292-2167
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC265204163W00000X
NC5020057363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse