Individual
MS. ANDREA MARAE CROCKTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
264 GREYSTONE LN, ROCHESTER, NY 14618-5129
(585) 503-9565
Mailing address
264 GREYSTONE LN, ROCHESTER, NY 14618-5129
(585) 503-9565
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295929
NY
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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