| NPI | 1861082398 |
|---|---|
| Former Name | CRYSTAL LYNN JOLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN02545) |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2022-01-26 |