Clova E Crisp, RPN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

505112-1 Issued in NY

Practice address

322 Cassa Loop
Holtsville, NY 11742-2622

Phone

(631) 758-2414

NPI assigned

Mar 12, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1689845182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 CASSA LOOP",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422622",
            "telephone_number": "631-758-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 CASSA LOOP",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422622",
            "telephone_number": "631-758-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "CLOVA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "RPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "505112-1",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "505112-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Costello, LCSW
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• Creative Health Unlimited
• Cvo Home for Female Veterans Inc
• Dennis Damato, M.S.W.
• Lynda Darling, LPN
• Heather Curran Davidson, AUD
• Christopher Dellaratta

• Registered Nurse in Holtsville, NY
• Providers in Holtsville, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.