| NPI | 1568887529 |
|---|---|
| Former Name | CRYSTAL ANN MCTAGGART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP125257) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 751631) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 751631) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2015-04-13 |