Individual
CRYSTAL VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
118 N COUNTRY RD, PORT JEFFERSON STATION, NY 11777-2120
(631) 751-3000
Mailing address
1 RESEARCH RD, RIDGE, NY 11961-2701
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404900
NY
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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