Crystal N Etheridge , LPN
Licensed Practical Nurse • Bellport, NY
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Crystal Etheridge has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Crystal Etheridge, LPN was a registered Licensed Practical Nurse practicing in Bellport, NY. Throughout an active medical career spanning 11 years, Crystal Etheridge provided care at the practice location at 319 STATION RD until profile deactivation on 2019-03-13.
Practice Location & Contact Primary Location
319 Station Rd
Bellport, NY 117132116
Specialty Benchmarks & Practice Insights
Comparative analytics for Licensed Practical Nurse in Bellport, NY
Practicing in Bellport, NY (23738 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 164W00000X
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Career & Practice History Timeline
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Record deactivated on March 13, 2019
NPI status registered as active in NPPES database
Registered at 319 STATION RD, BELLPORT, NY 117132116 (Tel: 7048984282)
Registered at 319 STATION RD, BELLPORT, NY 117132116 (Tel: 7048984282)
Recorded as CRYSTAL ETHERIDGE, LPN
Licensed Practical Nurse (License #292143 in NY)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
319 Station Rd
Bellport, NY 117132116
Phone: 7048984282
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