Lakeisha Bristow, NP
Nurse Practitioner in Middletown, NY. Individual provider (NPI-1).
NPI number1316581069
StatusActive
Last updated in NPPESNov 20, 2019
Details
- NPI
- 1316581069
- Entity type
- Individual (NPI-1)
- Name
- Lakeisha Bristow
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2019
- Last updated
- Nov 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | F309168 | NY | Yes |
Practice location
95 Crystal Run RdMiddletown, NY 10941-7001
Phone 845-703-6999 · Fax 845-703-6297
Mailing address
155 Crystal Run RdMiddletown, NY 10941-4028
Phone 845-703-6999 · Fax 845-703-6297
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