| NPI | 1013162981 |
|---|---|
| Former Name | CRYSTAL CELESTE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV APRN001888) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1418A) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2019-01-16 |