Provider Demographics
NPI:1811271539
Name:CROW, SUSAN JESSIE (NP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JESSIE
Last Name:CROW
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:14445 OLIVE VIEW DRIVE- NORTH ANNEX
Mailing Address - Street 2:OLIVE VIEW UCLA MEDICAL CENTER
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-364-3107
Mailing Address - Fax:
Practice Address - Street 1:14445 OLIVE VIEW DRIVE - NORTH ANNEX
Practice Address - Street 2:OLIVE VIEW-UCLA MEDICAL CENTER
Practice Address - City:SYMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2016-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA21073363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care