Healthcare Provider Details

I. General information

NPI: 1912208984
Provider Name (Legal Business Name): LAURIE BROWN-CROYTS RN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E MAIN ST
SPRINGVILLE NY
14141-1443
US

IV. Provider business mailing address

224 E MAIN ST
SPRINGVILLE NY
14141-1443
US

V. Phone/Fax

Practice location:
  • Phone: 716-592-2871
  • Fax: 716-592-8105
Mailing address:
  • Phone: 716-592-2871
  • Fax: 716-592-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP11812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: