Individual
MRS. CRYSTAL PARKER MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
902228
MS
363L00000X
Nurse Practitioner
902228
MS
363LF0000X
Family Nurse Practitioner
Primary
90228
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03882831
—
MS
Enumeration date
08/25/2017
Last updated
07/28/2020
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