Individual
CRYSTAL DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
740 S LIMESTONE ST, LEXINGTON, KY 40536-0284
(859) 323-8082
(859) 323-2441
Mailing address
740 S LIMESTOME E101, LEXINGTON, KY 40536-0284
(859) 323-8082
(859) 323-2441
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100138670
—
KY
Enumeration date
08/24/2010
Last updated
01/23/2015
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