Provider Demographics
NPI:1215930854
Name:CROZIER, RENAE LYNNE (FNP-BC)
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:LYNNE
Last Name:CROZIER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 W NORTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3748
Mailing Address - Country:US
Mailing Address - Phone:231-375-5251
Mailing Address - Fax:231-375-8439
Practice Address - Street 1:493 W NORTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-3748
Practice Address - Country:US
Practice Address - Phone:231-375-5251
Practice Address - Fax:231-672-8439
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL586224163WH0200X, 163W00000X, 163WI0500X
MI4704235273363LF0000X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN28430108OtherMEDICARE PTAN