Individual
JODY PUCKETT CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-FNP
Contact information
Practice address
571 S ALLEN RD, FLAT ROCK, NC 28731-9447
(828) 692-6178
(828) 692-2365
Mailing address
571 S ALLEN RD, FLAT ROCK, NC 28731-9447
(828) 692-6178
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5012460
NC
363LF0000X
Family Nurse Practitioner
Primary
5012460
NC
Other
Enumeration date
09/12/2019
Last updated
08/17/2022
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