Individual
MRS. CRYSTAL LYN COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
213 BURRITT RD, HILTON, NY 14468-9769
(585) 392-7847
Mailing address
213 BURRITT RD, HILTON, NY 14468-9769
(585) 392-7847
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
281099-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02712105
—
NY
Enumeration date
06/10/2007
Last updated
07/09/2007
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