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Individual

CRYSTAL MARCUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 964-5770
(405) 964-5788
Mailing address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 964-5770
(405) 964-5788

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
114855
OK
363LF0000X
Family Nurse Practitioner
Primary
114855
OK

Other

Enumeration date
10/14/2014
Last updated
06/26/2019
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