Individual
CRESTA LEE WALNOHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1479 3RD ST, BRILLIANT, OH 43913-1000
(740) 598-8296
Mailing address
1080 GREENS RUN RD, WELLSBURG, WV 26070-3053
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
131219
OH
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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