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General NPI Number Information
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NPI Number | 1235806100
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Entity Type | Individual
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Provider Name | CRYSTAL MARIE CZERWINSKI LPN
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Gender | Female
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 311 SPRUCE ST
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City | SAINT PAUL
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State | MN
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Zip | 55101-2446
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Country | US
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Telephone | 651-888-6822
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Fax |
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Provider Business Mailing Address
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Address Line | 233 42ND AVE NE APT 204
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City | COLUMBIA HEIGHTS
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State | MN
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Zip | 55421-2783
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Country | US
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Telephone | 507-319-5605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 737108
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License Number State | MN
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