Healthcare Provider Details

I. General information

NPI: 1093369027
Provider Name (Legal Business Name): CRYSTAL ELIZABETH SIGMUND CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 SHERMAN ST STE 2100
JAMESTOWN NY
14701-7087
US

IV. Provider business mailing address

17 SHERMAN ST STE 2100
JAMESTOWN NY
14701-7087
US

V. Phone/Fax

Practice location:
  • Phone: 716-664-8510
  • Fax: 716-664-8514
Mailing address:
  • Phone: 716-664-8510
  • Fax: 716-664-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number002489-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010547
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: