Provider Demographics
NPI:1396307948
Name:MILNER, CRYSTAL LYNN (CNA)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:MILNER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NICHOLS
Mailing Address - State:NY
Mailing Address - Zip Code:13812-2104
Mailing Address - Country:US
Mailing Address - Phone:607-414-1033
Mailing Address - Fax:
Practice Address - Street 1:178 W RIVER RD
Practice Address - Street 2:
Practice Address - City:NICHOLS
Practice Address - State:NY
Practice Address - Zip Code:13812-2104
Practice Address - Country:US
Practice Address - Phone:607-414-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide