| NPI | 1154783470 |
|---|---|
| Former Name | CRYSTAL KAY PENNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704239482) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704239482) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-01-09 |