Individual
MR. JOVAN ANTWUANE CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3623 WABASH AVE, BALTIMORE, MD 21215-7435
(410) 262-1063
Mailing address
3623 WABASH AVE, BALTIMORE, MD 21215-7435
(410) 262-1063
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R187195
MD
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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