Provider Demographics
NPI:1811429004
Name:CROSKEY, BRENDA
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CROSKEY
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 1:1424 R ST NW
Mailing Address - Street 2:APT 202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3866
Mailing Address - Country:US
Mailing Address - Phone:202-747-8174
Mailing Address - Fax:
Practice Address - Street 1:1424 R ST NW
Practice Address - Street 2:APT 202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3866
Practice Address - Country:US
Practice Address - Phone:202-747-8174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide