Marilyn Rae Crowther
Individual provider Active NPI Contractor · Aitkin, MN
NPI 1427375997 · NPPES record last updated Apr 23, 2010
Key facts
- NPI
- 1427375997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 1052834-1-AFC (MN)
- Practice address
- 34852 363Rd PL
Rocky Ridge Afc
Aitkin, MN 56431-5729 - Phone
- (218) 927-2755
- NPI assigned
- Apr 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1052834-1-AFC | MN | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 1052834-1-AFC | MN | Yes |
Addresses
Primary practice location
34852 363Rd PL
Rocky Ridge Afc
Aitkin, MN 56431-5729
Mailing address
34852 363Rd PL
Aitkin, MN 56431-5729
Phone (218) 927-2755
Other providers in Aitkin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.