Provider Demographics
NPI:1679795520
Name:CROSBY, MICHELLE VELVET (LPN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:VELVET
Last Name:CROSBY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2746
Mailing Address - Country:US
Mailing Address - Phone:614-496-3462
Mailing Address - Fax:
Practice Address - Street 1:903 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2746
Practice Address - Country:US
Practice Address - Phone:614-496-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2308989Medicaid