Individual
CRYSTAL KELLEY HARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 QUAIL RUN, CARROLLTON, GA 30116-1894
(678) 577-6273
Mailing address
102 QUAIL RUN, CARROLLTON, GA 30116-1894
(678) 577-6273
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN070918
GA
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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