JOVAN ANTWUANE CROCKER
Nurse Practitioner (Primary Care)

Address: 3623 Wabash Ave, Baltimore, MD 21215-7435

JOVAN ANTWUANE CROCKER (NPI# 1871188441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871188441
Entity Type Individual
Full Name MR. JOVAN ANTWUANE CROCKER
Gender Male
Credential CRNP
Practice Address 3623 Wabash Ave
Baltimore
MD 21215-7435
Practice Telephone 4102621063
Mailing Address 3623 Wabash Ave
Baltimore
MD 21215-7435
Mailing Telephone 4102621063
Certification Date 2021-03-05
Enumeration Date 2021-03-05
Last Update Date 2021-03-05
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
R187195 MD Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3623 WABASH AVE
City BALTIMORE
State MD
Zip Code 21215-7435

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1154946432 Kara Ashby Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Baltimore, MD 21215 2020-06-11
1871117895 Kalsoom Akhlaq Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Baltimore, MD 21215 2020-06-05
1598388399 Vishruth Reddy Vyata Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Balitmore, MD 21215 2020-05-27
1821611617 Faisal Ibrahim-Adam Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Baltimore, MD 21215 2020-05-27
1700409984 Rao Hamza Taheem Hashim Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Baltimore, MD 21215 2020-05-22
1962025387 Kinza Bazigh Student in an Organized Health Care Education/Training Program 2401 W. Belvedere Avenue, Baltimore, MD 21215 2020-05-20
1235751207 Chirayu Mohindroo Student in an Organized Health Care Education/Training Program 2401 W Belvedere Avenue, Baltimore, MD 21215 2020-05-13
1902428907 Shreyas Ashok Kalantri Student in an Organized Health Care Education/Training Program 2401 W Belvedere Avenue, Baltimore, MD 21215 2020-05-12
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1609468933 G & E Behavioral Health Services, LLC 224 N Gay St Ste 2, Baltimore, MD 21202-5886 2021-02-08
1154918738 Rachael Mcgee 301 Saint Paul St, Baltimore, MD 21202-2102 2020-12-29
1093310450 Weekend Whitecoat Concierge LLC 1034 Mcdonogh St, Baltimore, MD 21205-1110 2020-12-03
1619578168 Edgewellness LLC &nursing Services 7416 Harford Rd, Baltimore, MD 21234-7152 2020-11-02
1598364192 Folasade O Onasanya 3312 Croydon Rd, Baltimore, MD 21207-4543 2020-10-23
1831703677 Hands of Health Primary Care 4101 Glenhunt Rd, Baltimore, MD 21229-1705 2020-08-31
1437785706 Hajia M Nagaiya 3525 Courtleigh Dr, Baltimore, MD 21244-2205 2020-03-19
1841844222 Amaris Patrice Murray 2300 Garrison Blvd Ste 200, Baltimore, MD 21216-2309 2019-07-24
1033761796 Michael Louis Mincin 22 S Greene St, Baltimore, MD 21201-1544 2019-07-12
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Competitor

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City BALTIMORE
Zip Code 21215

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.