Provider Demographics
NPI:1154978732
Name:REYES-CRAWHORN, ANNA M
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:REYES-CRAWHORN
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 1:1507 SPRING STREET
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-2939
Mailing Address - Country:US
Mailing Address - Phone:407-347-4536
Mailing Address - Fax:812-285-8392
Practice Address - Street 1:1507 SPRING STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-2939
Practice Address - Country:US
Practice Address - Phone:812-901-6881
Practice Address - Fax:812-285-8392
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008870A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health