| Doctor Name: | DR. KIMBERLY CROCKER CROWTHER |
| NPI Number: | 1417293879 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, APRN, BC, FNP |
| License Number: | 168791NP |
| Business Practice Address: | 67d Main St. Medway, MA - 02053 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | 4016529787 |
| Mailing Address: | 1 Cvs Drive, WOONSOCKET |
| State: | RI |
| Postal Code: | 02895 |
| Phone Number: | 8663892727 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2012 |
| NPI Last Update Date: | 12/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 168791NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |