| NPI | 1548636715 |
|---|---|
| Former Name | KRYSTAL D LONGDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: IL 3213) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043117357) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2021-08-27 |