Cassie Dora Craft, LPN

Individual provider Active NPI Licensed Practical Nurse · Bolivar, NY

NPI 1831481878 · NPPES record last updated May 10, 2011

Key facts

NPI
1831481878
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
257577-1 (NY)
Practice address
82 Olive St
Bolivar, NY 14715-1310
Phone
(585) 928-1901
NPI assigned
May 10, 2011
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
257577-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 257577-1 NY Yes

Addresses

Primary practice location

82 Olive St
Bolivar, NY 14715-1310

Mailing address

6712 Wiscoy Mills Mills Rd
Fillmore, NY 14735-8657
Phone (585) 356-7757

Other providers in Bolivar, NY

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

Sources for this page

Verify at the official NPI Registry.