Individual provider · Type 1 NPI

Crystal Leak

Licensed Practical Nurse · Cleveland, OH

NPI number 1467113100 Active

Practice location

3540 Croton Aveenue
Cleveland, OH 44115

Call (216) 202-1017 Map

Fax (216) 361-1922

Mailing address

3540 Croton Ave
Cleveland, OH 44115-3212

Specialties and licenses

Taxonomy	Code	License
Licensed Practical Nurse Primary	164W00000X	164715 (OH)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1467113100

Crystal Leak's National Provider Identifier is 1467113100, issued on Jan 5, 2022. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Cleveland, OH. The record was last updated on Jan 5, 2022.