Provider Demographics
NPI:1942933429
Name:CROOM, ANGELA DENISE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DENISE
Last Name:CROOM
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 1:4542 3RD ST SE APT C
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3130
Mailing Address - Country:US
Mailing Address - Phone:202-652-1531
Mailing Address - Fax:
Practice Address - Street 1:3700 9TH ST SE APT 410
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4021
Practice Address - Country:US
Practice Address - Phone:202-889-5603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant