Provider Demographics
NPI:1639990823
Name:CROWDER, DEWAYNE NASHUN (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:DEWAYNE
Middle Name:NASHUN
Last Name:CROWDER
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PHOENIX BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5557
Mailing Address - Country:US
Mailing Address - Phone:404-901-0679
Mailing Address - Fax:678-705-3814
Practice Address - Street 1:1800 PHOENIX BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5557
Practice Address - Country:US
Practice Address - Phone:678-705-3814
Practice Address - Fax:770-758-1152
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty