Provider Demographics
NPI:1295465144
Name:CROWDER, YOLANDA N
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:N
Last Name:CROWDER
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 1:1520 WEST BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-7072
Mailing Address - Country:US
Mailing Address - Phone:704-999-4126
Mailing Address - Fax:
Practice Address - Street 1:1520 WEST BLVD STE J
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-7072
Practice Address - Country:US
Practice Address - Phone:704-999-4126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC6599251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC6599OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES