KEEGAN CROCKER PMHNP NPI 1639500739

NPI Information

NPI: 1639500739
Provider Name: KEEGAN CROCKER, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
11650 LANTERN RD STE 134
FISHERS, IN
ZIP 46038
Phone: (317) 992-1988
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Keegan Crocker, PMHNP is a psychiatric/mental health nurse practitioner in Fishers, IN. Keegan Crocker, PMHNP NPI is 1639500739. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11650 LANTERN RD STE 134
FISHERS, IN
ZIP 46038-101
Phone: (317) 992-1988
Fax: (317) 981-1694

The NPI 1639500739 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/28/2013 and was last updated on 12/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	71009042A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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