Healthcare Provider Details

I. General information

NPI: 1679487227
Provider Name (Legal Business Name): NANA CRENTSIL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 E WEST HWY
HYATTSVILLE MD
20782-2006
US

IV. Provider business mailing address

3605 E WEST HWY
HYATTSVILLE MD
20782-2006
US

V. Phone/Fax

Practice location:
  • Phone: 301-277-0199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31222
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: