Individual
CRYSTAL KUPSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 687-7300
Mailing address
317 30TH ST APT 310D, SPRINGFIELD, OR 97478-7655
(541) 556-7829
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201130520LPN
OR
Other
Enumeration date
12/24/2013
Last updated
12/24/2013
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