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1720107139
KRYSTAL I LEA
JEFFERSON CITY, MO
NPI
1720107139
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MO 2006030951)
Enumeration Date
2007-03-28
Last Update Date
2007-07-08
Business Address
KRYSTAL I LEA LPN
210 HOOVER ST
JEFFERSON CITY, MO 65109-0800
Phone number: 573-632-4321
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Mailing Address
KRYSTAL I LEA LPN
900 E LAHARPE ST
KIRKSVILLE, MO 63501-4520
Phone number: 660-665-1962
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