Provider Demographics
NPI:1205263548
Name:CROWDER, ETASHA NYA (CNM)
Entity type:Individual
Prefix:
First Name:ETASHA
Middle Name:NYA
Last Name:CROWDER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 PINEY BRANCH CIR APT 560
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1827
Mailing Address - Country:US
Mailing Address - Phone:202-421-3005
Mailing Address - Fax:
Practice Address - Street 1:301 SAINT PAUL ST STE 501
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-347-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife