Individual
CRYSTAL SUZANNE MULLINAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-3287
(864) 455-5723
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22421
SC
363LP2300X
Primary Care Nurse Practitioner
22421
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5880
—
SC
Enumeration date
02/14/2019
Last updated
02/07/2024
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