Basic Information
| Provider Information | |||||||||
| NPI: | 1003330523 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROWLEY | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37 FRIEND STREET | ||||||||
| Address2: | ELEMENT CARE INC | ||||||||
| City: | LYNN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817156608 | ||||||||
| FaxNumber: | 7817156699 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 BUFFUM ST. | ||||||||
| Address2: | ELEMENT CARE INC | ||||||||
| City: | LYNN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817150040 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2017 | ||||||||
| LastUpdateDate: | 07/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN2302923 | MA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.