Individual
CRYSTAL M PICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1088 ANDORA RD NE, CARROLLTON, OH 44615-9787
(330) 705-7222
Mailing address
1088 ANDORA RD NE, CARROLLTON, OH 44615-9787
(330) 705-7222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN. 115745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3031150
—
OH
Enumeration date
02/22/2010
Last updated
06/28/2011
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