Provider Demographics
NPI:1588809099
Name:CAVER, CRYSTAL LYNNE (LPN)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNNE
Last Name:CAVER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 BRIDLE PATH
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-7004
Mailing Address - Country:US
Mailing Address - Phone:513-236-5617
Mailing Address - Fax:
Practice Address - Street 1:686 BRIDLE PATH
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-7004
Practice Address - Country:US
Practice Address - Phone:513-236-5617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.110360-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse