Individual
ANDREA CRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
395 W COUGAR BLVD, PROVO, UT 84604-3311
(801) 357-7420
Mailing address
142 N 450 W, AMERICAN FORK, UT 84003-1499
(801) 859-7300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10378599-4405
UT
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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