# KHALILAH KRYSTAL LARUE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1255578548
- **Gender:** F
- **Credential:** CNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | COA. 10483 | OH | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RN305465 | GA | Yes |

## Other

- **Enumeration date:** 01/08/2009
- **Last updated:** 08/30/2021