| NPI | 1114494077 |
|---|---|
| Former Name | CRYSTAL JEAL DEAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK 97660) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 97660) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OK 00097660) | |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2022-01-11 |