Nisheda Crennel, LPN

Individual provider Active NPI Licensed Practical Nurse · Calverton, NY

NPI 1083464366 · NPPES record last updated Mar 27, 2024

Key facts

NPI
1083464366
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
349753-01 (NY)
Practice address
129 Hill Cres
Calverton, NY 11933-1708
Phone
(631) 294-6455
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
349753-01NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 349753-01 NY Yes

Addresses

Primary practice location

129 Hill Cres
Calverton, NY 11933-1708

Mailing address

129 Hill Cres
Calverton, NY 11933-1708
Phone (631) 294-6455

Other providers in Calverton, NY

All providers in Calverton, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.