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Contact Information

CRYSTALCARE
3124 N SHILOH ROAD
CORINTH, MS38834
 Phone: 901-292-2964
 Fax: 662-762-0690
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for CRYSTALCARE · (Female)

NPI Number 1477176824
Status Active
Credentials
Entity Individual
Enumeration date 05/20/2020
Last updated 11/18/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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