Individual provider · Type 1 NPI

Tanya Ezell Crockett, APRN, CPNP-PC

Pediatric Nurse Practitioner · Louisville, KY

NPI number 1740564954 Active

Practice location

231 E Chestnut St
Louisville, KY 40202-1821

Call (502) 629-4750 Map

Fax (502) 629-4617

Mailing address

PO Box 776879
Chicago, IL 60677-6879

Other practice locations

  • 496 Southland Dr, Lexington, KY 40503-1827 · (859) 288-2425

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X3007181 (KY)

Pediatric Nurse Practitioner: Definition to come...

332 other providers at this address

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About NPI 1740564954

Tanya Ezell Crockett, APRN, CPNP-PC's National Provider Identifier is 1740564954, issued on Oct 6, 2011. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Louisville, KY. The record was last updated on Feb 24, 2026.