Individual
CHRISTELLE FREDA DESMORNESNESBITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 N NEWARK ST, PHELPS, NY 14532-9709
(718) 970-0011
Mailing address
10 N NEWARK ST, PHELPS, NY 14532-9709
(718) 970-0011
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
34414401
NY
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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