| NPI | 1437870680 |
|---|---|
| Former Name | CRYSTAL A WHITEAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13139) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 241942) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2023-03-16 |