Individual
CRYSTA DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
104 DAVENTRY LN, LOUISVILLE, KY 40223-2883
(502) 200-7043
Mailing address
104 DAVENTRY LANE, LOUISVILLE, KY 40223
(502) 200-7043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3017544
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3017544
APRN LICENSE NUMBER
KY
Enumeration date
03/11/2022
Last updated
04/21/2026
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