Provider Demographics
NPI:1477435097
Name:CRANK, AYANA
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:
Last Name:CRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 DUVEL ST
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-9649
Mailing Address - Country:US
Mailing Address - Phone:443-743-5641
Mailing Address - Fax:
Practice Address - Street 1:2307 N ROLLING RD
Practice Address - Street 2:25
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244
Practice Address - Country:US
Practice Address - Phone:443-402-8951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD453123174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist