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CRYSTAL LEAK
NPI 1467113100
Licensed Practical Nurse in Cleveland, OH

Active since January 05, 2022
3540 CROTON AVEENUE, CLEVELAND, OH 44115(216) 202-1017(216) 361-1922 Get Directions Write a Review

NPPES record last updated: January 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Crystal Leak NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL LEAK (NPI 1467113100) is an individual licensed practical nurse in Cleveland, Ohio, licensed in Ohio (164715) and active in the NPI registry since January 2022.

NPPES Registry Identity

NPI1467113100
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameCRYSTAL LEAK
Location Address3540 CROTON AVEENUECleveland, OH 44115
Mailing Address3540 Croton AveCleveland, OH 44115-3212 · (216) 202-1017 · Fax (216) 361-1922
Phone(216) 202-1017
Fax(216) 361-1922
Sole ProprietorNo
Enumeration DateJanuary 5, 2022
NPPES CertifiedJanuary 4, 2022
✔ NPI 1467113100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OH · 164715
Definition
A licensed practical nurse 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.
3540 CROTON AVEENUE, Cleveland, OH 44115
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Leak's NPI number?

The NPI number for Crystal Leak is 1467113100. It was assigned to this individual provider in the NPPES registry on January 5, 2022.

Where is Crystal Leak located?

Crystal Leak practices at 3540 Croton Aveenue, Cleveland, OH 44115. The listed phone number is (216) 202-1017.

What is Crystal Leak's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Crystal Leak was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.