| NPI | 1982126306 |
|---|---|
| Former Name | CRYSTAL ROSE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9294210) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F05170126) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2018-07-31 |