| NPI | 1215565460 |
|---|---|
| Former Name | CRYSTAL ANN PARKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-151057) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-151057) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-02-19 |