Individual
CHRYSTAL RENEE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1035 WOODHILL, NEWARK, NY 14513-2047
(315) 359-1967
Mailing address
1035 WOODHILL, NEWARK, NY 14513-2047
(315) 359-1967
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327579-1
NY
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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