Individual
CRYSTAL SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
95 BRYAN BLVD, SUITE 202, CORBIN, KY 40701-2788
(606) 523-3021
(606) 523-3040
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1822
KY
363AM0700X
Medical Physician Assistant
PA1822
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100294880
—
KY
Enumeration date
07/29/2013
Last updated
03/27/2015
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