Organization
ADULT AND GERIATRIC HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL SHUANDALE KILLIAN NP (OWNER)
(828) 228-5326
Entity
Organization
Contact information
Practice address
325 1ST AVE SW, HICKORY, NC 28602-2940
(828) 228-5326
Mailing address
325 1ST AVE SW, HICKORY, NC 28602-2940
(828) 228-5326
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114493111
—
NC
Enumeration date
08/12/2022
Last updated
08/12/2022
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