Provider Demographics
NPI:1689481897
Name:CROWE, LATOSHA
Entity type:Individual
Prefix:
First Name:LATOSHA
Middle Name:
Last Name:CROWE
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 1:602 SWEET CREEK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-7801
Mailing Address - Country:US
Mailing Address - Phone:463-212-9902
Mailing Address - Fax:
Practice Address - Street 1:602 SWEET CREEK DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-7801
Practice Address - Country:US
Practice Address - Phone:463-212-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care