Provider Demographics
NPI:1831409275
Name:CRAWFORD, JEANNE M (LPN)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:M
Last Name:CRAWFORD
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 1:441 MACEDON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-9373
Mailing Address - Country:US
Mailing Address - Phone:585-208-3084
Mailing Address - Fax:
Practice Address - Street 1:441 MACEDON CENTER RD
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-9373
Practice Address - Country:US
Practice Address - Phone:585-208-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298429164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse