Provider Demographics
NPI:1023802485
Name:JACKSON, CRASHAWN TOYA (NURSE AIDE)
Entity type:Individual
Prefix:
First Name:CRASHAWN
Middle Name:TOYA
Last Name:JACKSON
Suffix:
Gender:F
Credentials:NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3361 SW 44TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5588
Mailing Address - Country:US
Mailing Address - Phone:954-831-9402
Mailing Address - Fax:
Practice Address - Street 1:3361 SW 44TH ST APT 1
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5588
Practice Address - Country:US
Practice Address - Phone:954-831-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide