Individual
CRYSTAL DANAE VAN DETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2919W SWANN AVE 102, TAMPA, FL 33609-4049
(813) 870-3971
Mailing address
2919W SWANN AVE 102, TAMPA, FL 33609-4049
(813) 870-3971
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP 9268840
FL
Other
Enumeration date
03/17/2014
Last updated
08/17/2015
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