Individual
MRS. IMELDA R CRUMMETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
218 OGLE AVE, RIO DELL, CA 95562-1013
(707) 764-5089
Mailing address
218 OGLE AVE, RIO DELL, CA 95562-1013
(707) 764-5089
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN135430
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EPS012410
EPS
CA
01
—
RVN001000
RVN
CA
Enumeration date
02/02/2007
Last updated
07/08/2007
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