MEDICARE: DEBBIE CHRISPELL LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	301210-1	NY

General Provider Information

NPI Number	:	1295049005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE CHRISPELL LPN

Provider Business Mailing Address
First Line	:	RR 2 BOX 416
Second Line	:
City	:	ROME
State	:	PA
Zip	:	18837-9560
Country	:	US
Telephone Number	:	570-395-3783
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 FRONT ST
Second Line	:
City	:	BINGHAMTON
State	:	NY
Zip	:	13905-4712
Country	:	US
Telephone Number	:	607-722-6461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	08/04/2010

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