Individual
KRYSTAL ANNE FAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
706 W BARNARD ST, GLENNVILLE, GA 30427-3017
(812) 822-1941
Mailing address
505 N CLARK ST, CLAXTON, GA 30417-1516
(912) 531-0616
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN213761
GA
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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