Provider Demographics
NPI:1144504390
Name:CRICKS, RICHELLE JOANNE (CNM)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:JOANNE
Last Name:CRICKS
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:250 W PRATT ST
Mailing Address - Street 2:STE 880
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6829
Mailing Address - Country:US
Mailing Address - Phone:667-214-1302
Mailing Address - Fax:410-328-3379
Practice Address - Street 1:419 W REDWOOD ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1734
Practice Address - Country:US
Practice Address - Phone:667-214-1300
Practice Address - Fax:410-328-3379
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2016-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMW010253367A00000X
MDR221356367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife