Shanatha Crandall, LPN is a
Licensed Practical Nurse based in Millport, New York. Shanatha Crandall is licensed to practice in New York (license number 326639) and her current practice location is
58 New Rd, Millport, New York. She can be reached at her office (for appointments etc.) via phone at
(607) 259-6495.
NPI number for Shanatha Crandall is 1205429875 and her current mailing address is 58 New Rd, Millport, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1205429875.
Provider's Profile
| Full Name | Shanatha Crandall |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
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| Location | 58 New Rd, Millport, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205429875
- Provider Enumeration Date: 02/15/2021
- Last Update Date: 02/15/2021
Medical Identifiers
Medical identifiers for Shanatha Crandall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205429875 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 326639 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shanatha Crandall is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shanatha Crandall, LPN
58 New Rd,
Millport, NY 14864-9764
Ph: (607) 259-6495 | Shanatha Crandall, LPN
58 New Rd,
Millport, NY 14864-9764
Ph: (607) 259-6495 |
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