National Provider Identifier

Shanatha Crandall, LPN

Shanatha Crandall, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Millport, NY and a listed phone number of (607) 259-6495.

NPI 1205429875Millport, NYLicensed Practical Nurse

Profile Overview

NPI
1205429875
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021

Practice Location

  • 58 New RD
  • Millport, NY 14864-9764

Phone: (607) 259-6495

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1205429875
Entity Type
Individual
Last Name
Crandall
First Name
Shanatha
Credential
LPN
Mailing Street Address
58 New RD
Mailing City
Millport
Mailing State
NY
Mailing ZIP Code
14864-9764
Mailing Country
US
Mailing Phone
(607) 259-6495
Mailing Fax
(607) 398-2064
Practice Street Address
58 New RD
Practice City
Millport
Practice State
NY
Practice ZIP Code
14864-9764
Practice Country
US
Practice Phone
(607) 259-6495
Practice Fax
(607) 398-2064
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021
Sex
Female
Sole Proprietor
Yes
Certification Date
February 15, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)