Individual
CRISTIN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1680 WALDEN AVE, CHEEKTOWAGA, NY 14225-4914
(716) 894-7777
(716) 894-0604
Mailing address
3807 CORNELL ST, HAMBURG, NY 14075-2719
(716) 208-0232
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
297158
NY
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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