Provider Demographics
NPI:1912519273
Name:CROWLEY, LISA (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, PMHNP-BC
Mailing Address - Street 1:1942 BROADWAY STE 314C
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5233
Mailing Address - Country:US
Mailing Address - Phone:321-234-7370
Mailing Address - Fax:
Practice Address - Street 1:1942 BROADWAY STE 314C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5233
Practice Address - Country:US
Practice Address - Phone:321-234-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0101477-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health