Individual
CRYSTAL VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 TOWNSHIP ROAD 1276, SOUTH POINT, OH 45680-7315
(304) 633-0729
Mailing address
175 TOWNSHIP ROAD 1276, SOUTH POINT, OH 45680-7315
(304) 633-0723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN92035-FNP-BC
WV
363LF0000X
Family Nurse Practitioner
COA.16752-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115264
—
OH
05
—
3810028359
—
WV
Enumeration date
10/29/2014
Last updated
04/14/2021
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