Provider Demographics
NPI:1861834111
Name:LASHLEY, CRYSTAL L (RN, RRT)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:L
Last Name:LASHLEY
Suffix:
Gender:F
Credentials:RN, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13314 231ST ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2120
Mailing Address - Country:US
Mailing Address - Phone:347-678-6394
Mailing Address - Fax:
Practice Address - Street 1:13314 231ST ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2120
Practice Address - Country:US
Practice Address - Phone:347-678-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY445499163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse