Provider Demographics
NPI:1679383905
Name:CROUCH, CARRA (RN)
Entity type:Individual
Prefix:
First Name:CARRA
Middle Name:
Last Name:CROUCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11232 OCTOBER STEAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2564
Mailing Address - Country:US
Mailing Address - Phone:949-929-2075
Mailing Address - Fax:
Practice Address - Street 1:8600 WURZBACH
Practice Address - Street 2:SUITE 801
Practice Address - City:SAN ANTONIO
Practice Address - State:US
Practice Address - Zip Code:78229
Practice Address - Country:UM
Practice Address - Phone:210-767-9556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1046382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse