Basic Information
| Provider Information | |||||||||
| NPI: | 1538766431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROSBY | ||||||||
| FirstName: | JANA | ||||||||
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| Credential: | NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2955 W STUART ST APT 8 | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805266619 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 22999 HIGHWAY 59 N | ||||||||
| Address2: | |||||||||
| City: | KINGWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773394412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813488000 | ||||||||
| FaxNumber: | 2813488398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2020 | ||||||||
| LastUpdateDate: | 10/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0000X | AP122914 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |
No ID Information.