Individual
AUTUMN NICHOLE CRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 VALLEY CT # 5, MOUNT HOPE, WV 25880-9294
(305) 663-5011
Mailing address
784 LUCAS RD, VICTOR, WV 25938-6706
(304) 663-5011
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
82678
WV
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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