| Doctor Name: | MRS. CLOVA E CRISP |
| NPI Number: | 1689845182 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPN |
| License Number: | 505112-1 |
| Business Practice Address: | 322 Cassa Loop Holtsville, NY - 117422622 |
| Business Phone Number: | 6317582414 |
| Business Fax Number: | |
| Mailing Address: | 322 Cassa Loop, HOLTSVILLE |
| State: | NY |
| Postal Code: | 117422622 |
| Phone Number: | 6317582414 |
| Fax Number: | |
| NPI Enumeration Date: | 03/12/2008 |
| NPI Last Update Date: | 03/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0600X |
| License Number: | 505112-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |