Individual
CRYSTAL ANN SHAGENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
9920 LAZY OAK DR, CARLETON, MI 48117-9643
(734) 755-5993
Mailing address
9920 LAZY OAK DR, CARLETON, MI 48117-9643
(734) 755-5993
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704261257
MI
363LF0000X
Family Nurse Practitioner
4704261257
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704261257
MI
Other
Enumeration date
07/25/2020
Last updated
11/05/2020
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