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Individual

STEPHANIE MARIAN CRISPELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, EMT-B

Contact information

Practice address
510 INDUSTRIAL DR, LEWISBERRY, PA 17339-9597
(717) 919-3252
Mailing address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(800) 974-5774

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
216361
PA
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
216361
PA DEPARTMENT OF HEALTH - EMT-B
PA
Enumeration date
02/01/2017
Last updated
02/01/2017
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