CRYSTALCARE NPI 1477176824

NPI Information

  • NPI: 1477176824
  • Provider Name: CRYSTALCARE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 3124 N SHILOH ROAD
    CORINTH, MS
    ZIP 38834
  • Phone: (901) 292-2964

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NPI Details

CRYSTALCARE is a family nurse practitioner in Corinth, MS. CRYSTALCARE NPI is 1477176824. The provider is registered as an organization entity type.

The provider's business location address is:

3124 N SHILOH ROAD
CORINTH, MS
ZIP 38834
Phone: (901) 292-2964
Fax: (662) 762-0690

The provider's authorized official is Crystal Rose Wilson .
The authorized official title is Owner and has the following contact phone number (901) 292-2964.

The enumeration date for this NPI number is 5/20/2020 and was last updated on 11/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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