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General NPI Number Information
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NPI Number | 1639990823
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Entity Type | Individual
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Provider Name | DEWAYNE NASHUN CROWDER SOCIAL WORKER
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Gender | Male
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1800 PHOENIX BLVD STE 210
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City | ATLANTA
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State | GA
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Zip | 30349-5557
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Country | US
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Telephone | 678-705-3814
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Fax | 770-758-1152
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Provider Business Mailing Address
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Address Line | 1800 PHOENIX BLVD STE 210
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City | ATLANTA
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State | GA
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Zip | 30349-5557
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Country | US
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Telephone | 404-901-0679
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Fax | 678-705-3814
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0600X
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Taxonomy Name | Infection Control Registered Nurse
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License Number | RN304533
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License Number State | GA
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