Provider Demographics
NPI:1497992747
Name:CREVIER, DEBORAH JAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JAY
Last Name:CREVIER
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 1:26 KEELER RD
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-2324
Mailing Address - Country:US
Mailing Address - Phone:508-234-4830
Mailing Address - Fax:508-234-3885
Practice Address - Street 1:26 KEELER RD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-2324
Practice Address - Country:US
Practice Address - Phone:508-234-4830
Practice Address - Fax:508-234-3885
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA54833164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse