| NPI | 1043514193 |
|---|---|
| Former Name | CRYSTAL MARIE INGERSOLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 720890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 720890) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2018-05-04 |