Provider Demographics
NPI:1770173866
Name:CRAWFORD, AKIRAH SIMONE
Entity type:Individual
Prefix:
First Name:AKIRAH
Middle Name:SIMONE
Last Name:CRAWFORD
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 1:201 N 9TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-1713
Mailing Address - Country:US
Mailing Address - Phone:202-812-1402
Mailing Address - Fax:
Practice Address - Street 1:201 N 9TH ST APT 3A
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-1713
Practice Address - Country:US
Practice Address - Phone:202-812-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJASDS978374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula