National Provider Identifier

Crystal Nichole Davern, LPN

Crystal Nichole Davern, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Depew, NY and a listed phone number of (716) 715-7004.

NPI 1083116719Depew, NYLicensed Practical Nurse

Profile Overview

NPI
1083116719
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
March 08, 2018
Last Updated
March 08, 2018

Practice Location

  • 8 Deepwood Ct
  • Depew, NY 14043-4244

Phone: (716) 715-7004

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1083116719
Entity Type
Individual
Last Name
Davern
First Name
Crystal
Middle Name
Nichole
Credential
LPN
Provider Other Last Name
Frohnheiser
Provider Other First Name
Crystal
Provider Other Middle Name
Nichole
Provider Other Name Prefix Text
MS.
Provider Other Credential Text
LPN
Provider Other Last Name Type Code
1
Mailing Street Address
8 Deepwood Ct
Mailing City
Depew
Mailing State
NY
Mailing ZIP Code
14043-4244
Mailing Country
US
Mailing Phone
(716) 715-7004
Practice Street Address
8 Deepwood Ct
Practice City
Depew
Practice State
NY
Practice ZIP Code
14043-4244
Practice Country
US
Practice Phone
(716) 715-7004
Enumeration Date
March 08, 2018
Last Updated
March 08, 2018
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)