Provider Demographics
NPI:1083738041
Name:CROSTON-MURRAY, LORRAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:
Last Name:CROSTON-MURRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BROOKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-1539
Mailing Address - Country:US
Mailing Address - Phone:315-637-0599
Mailing Address - Fax:
Practice Address - Street 1:106 BROOKSIDE LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066-1539
Practice Address - Country:US
Practice Address - Phone:315-637-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY434008163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse