| NPI | 1801381645 |
|---|---|
| Former Name | KRYSTEN LEEANN CROSSLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AL 1346) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3576) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2021-09-01 |