Individual
CHRISTAL HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
545 VENTURE CT, MONTICELLO, GA 31064-7788
(706) 468-7002
Mailing address
545 VENTURE CT, MONTICELLO, GA 31064-7788
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN220103
GA
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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