Individual
KRYSTAL LYNN CRECELIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD # B902, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017024419
MO
363LF0000X
Family Nurse Practitioner
209017720
IL
Other
Enumeration date
03/23/2017
Last updated
03/19/2024
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