Basic Information
| Provider Information | |||||||||
| NPI: | 1144504390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRICKS | ||||||||
| FirstName: | RICHELLE | ||||||||
| MiddleName: | JOANNE | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 W PRATT ST | ||||||||
| Address2: | STE 880 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212016829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141302 | ||||||||
| FaxNumber: | 4103283379 | ||||||||
| Practice Location | |||||||||
| Address1: | 419 W REDWOOD ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141300 | ||||||||
| FaxNumber: | 4103283379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2011 | ||||||||
| LastUpdateDate: | 04/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | MW010253 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | R221356 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.