Provider Demographics
NPI:1003306309
Name:CROWDERS, CHRISTINA M (LPN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:CROWDERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-3522
Mailing Address - Country:US
Mailing Address - Phone:937-510-0724
Mailing Address - Fax:
Practice Address - Street 1:6929 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2563
Practice Address - Country:US
Practice Address - Phone:937-259-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.162511.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse