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Individual

DR. JASON MATTHEW CRISP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
650 JOEL DR, FT CAMPBELL, KY 42223
(270) 798-8388
Mailing address
562 JUSTIFY DR, HOPKINSVILLE, KY 42240-7914
(210) 725-5821

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1126653
KY
363LF0000X
Family Nurse Practitioner
29942
TN

Other

Enumeration date
10/02/2013
Last updated
10/04/2023
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