Provider Demographics
NPI:1487068011
Name:CROSWELL, JENNIFER MILLER (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MILLER
Last Name:CROSWELL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:HELGA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:540 GAITHER RD
Mailing Address - Street 2:ROOM 6111
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:540 GAITHER RD
Practice Address - Street 2:ROOM 6111
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6649
Practice Address - Country:US
Practice Address - Phone:301-427-1638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0355082083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine