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General NPI Number Information
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NPI Number | 1497072672
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Entity Type | Individual
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Provider Name | CRYSTAL RENEE POLAND RN
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Gender | Female
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 209 SENECA AVE STE A
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City | BYESVILLE
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State | OH
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Zip | 43723-1364
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Country | US
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Telephone | 740-685-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 3234 CLOVER RD
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City | CUMBERLAND
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State | OH
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Zip | 43732-9706
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Country | US
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Telephone | 740-260-4127
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 369443
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License Number State | OH
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